Patient's question:
AgeDetailed medical condition and consultation purpose: The menstrual cycle has been 32 days long. Last month, the period lasted 25 days and started on November 1st. From November 1st to November 6th, menstruation occurred, and since November 13th, there has been blood-tinged vaginal discharge. How should this be treated, and what medication should be used?
Auxiliary tests: After examination:
Ultrasound: Pelvic effusion;
Colposcopy: Abundant blood-tinged vaginal discharge, partial squamous epithelial shedding of the cervix, not yet covered by columnar epithelium. The erosion surface is red, smooth, and the cervix turns locally white after applying 3% acetic acid; after applying iodine solution, the normal squamous epithelial areas are stained brownish, while the erosion area, covered by columnar epithelium, does not stain after applying iodine.
Doctor's answer:
Hello: Based on your condition, it is likely caused by cervical erosion and pelvic inflammatory disease. You should actively treat the cervical erosion while undergoing anti-inflammatory therapy. There are many methods for treating cervical erosion, and appropriate choices can be made based on the severity of the erosion. The main methods are as follows:（1）Medication: For small erosion areas with superficial inflammation, the following medication treatments can be used:
① 10–20% silver nitrate: Topically applied once a week, with 2–4 applications constituting one course.
② Potassium permanganate: Applied locally after menstruation, followed by a repeat application after 1–2 months. When using these medications, caution is required to prevent burns to the surrounding vaginal wall. Additionally, proper disinfection should be maintained during application to prevent reinfection.
（2）Physical Therapy: Used for larger erosion areas with deeper inflammation.
① Electrocautery: A specialized electrocautery device is used to burn the eroded tissue, causing it to necrose and fall off. The treatment must reach a certain depth for optimal results.
② Cryotherapy: A specialized rapid-freezing device is used to freeze, necrose, and detach the diseased tissue on the cervical erosion surface. Liquid nitrogen is commonly used as the cryoprotectant, with the cryoprobe temperature reaching -196°C. It is applied to the surface of the cervix to freeze and necrose the eroded tissue, which then falls off and allows new squamous epithelial tissue to regenerate. One session is typically sufficient for cure. Generally, there are no adverse reactions, though some patients may experience mild dizziness or lower abdominal pain.
③ Laser Therapy: Carbon dioxide laser treatment devices are commonly used. A specialized laser applicator is used to irradiate the eroded cervical tissue, causing carbonization, scab formation, and detachment, followed by the regeneration of new squamous epithelial tissue.