A Simple Guide to Cervicitis

A Simple Guide to Cervicitis
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What is Cervicitis?
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Cervicitis is non-specific infection of the cervix.

It is most common on the posterior cervix but may be anterior or concentric.


Who is affected by Cervicitis?
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1.Congeital cervical erosions or cervicitis can occur in virgins.

2.sexually active females

3.dilatation in labor or during abortion

What are the types of Cervicitis?
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1.Simple:

Erosion surface is smooth

2.Papillary:

Erosion surface is rough

3.Follicular:

Erosion surface is cystic

What are the Causes of Cervicitis?
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Bacterial infections:
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1.Gonorrhea

2.Chlamydia

3.staphylococcus aureus

4.Streptococcus

5.Mycobacterium tuberculosis.

6.E.coli

Viral infections:
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1.Genital herpes

2.Human Papilloma Virus

Other causes:
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1.Cervical cap

2.Device to support the uterus (pessary)

3.Diaphragm

4.allergy to spermicides

5.Exposure to a chemical

What are the complications of Cervicitis?
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1.Pelvic inflammatory disease

2.Urethritis and cystitis

3.rarely malignant changes in cervix

4.inguinal lymphadenitis

5.Cervical cancer

What are the Symptoms and signs of Cervicitis?
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1.Mucopurulent vaginal discharge (Gray, white, or yellow color) with odor

2.Blood in the vaginal discharge
a.After intercourse
b.After menopause
c.Between periods

3.Urinary infection symptoms - frequency and pain

3.hematuria (blood in the urine)

4.Pelvic pain

5.Backache

6.Painful sexual intercourse

7.Pain in the vagina

8.Pressure or heaviness in the pelvis

Signs:

1.reddened area of cervix

2.erosion of cervical wall

3.Vaginal surface of cervix may be affected

4.pus discharge from the cervix

5.Swelling (inflammation) of the walls of the vagina

How is diagnosis of Cervicitis made?
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1.Vaginal examination with Pap's smear of cervical cells

2.Cervical swab for culture and sensitivity to antibiotics

3.Blood tests( white cell count , blood culture, chlamydia, gonorrhea)

4.Biopsy of cervical erosions.

What is the treatment of Cervicitis?
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1. Antibiotics is given according to the sensitivity of bacteria in the culture.

2.Pelvic pain and backache may be treated with paracetamol

3.Local application of sulphonamide, tetracycline or other antibiotic cream to affected cervical area

4.Electro-Cauterisation of the affected cervical area

5.Cryosurgery of cervical erosions

6.Cone biopsy if necessary of affected cervix area.

7.Hormonal therapy (especially in postmenopausal women)

8.Laser therapy of cervical erosions

What is the prognosis of Cervicitis?
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Prognosis with appropriate treatment and antibiotics is generally good.

Recurrence is common.

Cervicitis may last for months to years.

Cervicitis may lead to pain with intercourse (dyspareunia).

What are Preventive measures for Cervicitis?
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Avoid sexual intercourse with multiple partners.

Use condoms during sexual intercourse.

Vaccination against human papilloma virus

Avoid chemical irritants such as douches and deodorant tampons.

Avoid using spermicidal contraceptives

Make sure that any foreign objects that inserted into the vagina is clean or sterile

A Simple Guide to Ovarian Cancer

A Simple Guide to Ovarian Cancer
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What is Ovarian Cancer?
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Ovarian Cancer is a disease which cause abnormal cells in the ovary to proliferate and spread to the rest of the ovary or outside the ovary.

What are the different types of Ovarian Cancer?
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Most experts group ovarian cancers within three major categories, according to the kind of cells from which they were formed:

1.epithelial tumors arise from cells that line or cover the ovaries;

2.germ cell tumors originate from cells that are destined to form eggs within the ovaries; and

3.sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together and produce female hormones.

The most common type, the epithelial carcinoma, that begins from the surface of the ovary is discussed here.

Who is at risk of Ovarian Cancer?
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The cause of cancer of the ovary is unknown.
However, studies show that certain factors may increase the chance of developing this disease. 1.family history of ovarian cancer.

2.history of cancer of the breast or colon.

3.age over 60 years.

4. Infertility or not having children. The more children you have, the lesser your risk is.

5.Early menstruation before the age of 12

6.late menopause

7.high fat diet

8.Use of fertility drugs, or Hormone Replacement Therapy (HRT).

Attempts are being made to detect early stages of ovarian cancer, especially among women who have an increased risk. A blood test is done to check for a substance called CA 125.
If the sample contains raised amounts of CA 125, an ultrasound scan may be done to see if your ovaries appear abnormal in any way.

What are the Symptoms of Ovarian Cancer?
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Ovarian cancer is the most dangerous of gynaecological cancers because it is often silent and difficult to detect.There is no early detection method, so you must be vigilant and take note of persistent warning signs seriously.

If you are having some of the following symptoms persisting for more than a week or so, see your doctor.
1.Vague gastrointestinal symptoms such as gas, indigestion, nausea and a bloated feeling

2.Swelling in the abdomen, unexplained weight gain

3.Pelvic or abdominal pain or discomfort, and/or feeling of fullness

4.Urinary symptoms e.g. frequency and/or urgency of urination in the absence of an infection

5.Unexplained or changes in bowel habits

6.Loss of appetite/loss of weight

7.backache or pain inthe legs

8.Abnormal vaginal bleeding, although this is rare

If you do have any of the above symptoms you must have them checked by your doctor. Remember, they are non specific and most women with these symptoms will not have cancer.

How do you make the diagnosis of Ovarian Cancer?
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If you are at risk of ovarian cancer, see your gynaecologist regularly.

The following may be done:
recto-vaginal bimanual pelvic exam,

Pap smear,

blood test for CA-125

transvaginal ultrasound

What are the treatment of Ovarian Cancer?
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Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease) and the general health of the patient.
Surgery, chemotherapy and various types of radiotherapy may be used alone, or in combination to treat ovarian cancer.

Surgery
Surgery is normally the first choice of treatment for ovarian cancer, and may sometimes also be needed to make the diagnosis. If detected is in the early stages, surgery is all the treatment that may be required. The ovaries, fallopian tubes, uterus and cervix are usually removed. The omentum and lymph nodes in the abdomen are often removed too.

If the surgeon feels the cancer may be difficult to remove, a few cycles of chemotherapy may be applied first and surgery carried out thereafter, in the hope that the tumour would have been reduced.

Chemotherapy
Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be applied before surgery is carried out.

Radiotherapy
Radiotherapy is less commonly used in this cancer but may sometimes be used to treat individual areas of cancer which have recurred after surgery and chemotherapy.

Hormone Therapy

There have been many reports of the potential benefits of hormone treatments in patients with ovarian cancer that does not respond to conventional therapy.

Some patients with treatment-resistant (refractory) epithelial cancers have been treated with:
1.progestins - crude forms of the female sex hormone progesterone;

2.estrogens - for example, diethylstilbestrol
3.combination estrogen/progestin therapy;
4.antiestrogens - tamoxifen;
5.androgens - male sex hormones for example, Halotestin
6.gonadotropin-releasing hormone (GnRH) - a hormone of the hypothalamus that stimulates the release of ovary-related hormones from the pituitary gland.

Gene Therapy

Gene therapy eventually may provide some control over cancer susceptibility and its treatment. Ovarian cancer, like all cancers, is believed to result from a build-up of genetic defects within the cells.Genetic engineers hope to correct such damage by transplanting copies of normal genes into cells with genetic defects. However at the moment gene therapy is still experimental.