Patient's question:
AgeDetailed medical history 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, normal squamous epithelial areas turn brownish, while the erosion area, covered by columnar epithelium, does not stain after iodine application.
Doctor's answer:
Hello: Based on your condition, it is likely caused by cervical erosion and pelvic inflammatory disease. It is important to actively treat the cervical erosion while also 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 methods can be used:
① 10–20% silver nitrate: Apply locally once a week, with 2–4 applications constituting one course.
② Potassium permanganate: Apply locally after menstruation, and repeat the medication once after 1–2 months. When using these medications, be cautious to prevent burns to the surrounding vaginal wall, and ensure proper disinfection during application to prevent reinfection.
（2）Physical Therapy: Used for larger erosion areas with deeper inflammation.
① Electrocautery: Use a special electrocautery device to burn the erosion tissue, causing it to necrotize and fall off. It is important to achieve a certain depth for better treatment effects.
② Cryotherapy: Use a special rapid freezing device to freeze, necrotize, and cause the diseased cervical erosion tissue to fall off. Liquid nitrogen is commonly used as the cryogenic agent, which can lower the temperature of the cryotherapy device's tip to -196°C. Apply it to the surface of the cervix to freeze and necrotize the erosion tissue, causing it to fall off and allow new squamous epithelial tissue to regenerate. It can be cured in one session. Generally, there are no adverse reactions, although some patients may experience mild dizziness or lower abdominal pain.
③ Laser Therapy: Most commonly uses a carbon dioxide laser therapy device. Apply the special laser treatment head to irradiate the cervical erosion tissue, causing it to carbonize, form a scab, and fall off, followed by the regeneration of new squamous epithelial tissue.