Patient's question:
I have second-degree cervical erosion, which has caused a urinary tract infection. Now, as the urinary tract infection is becoming more severe, I want to cure the erosion. However, I have not given birth yet. Therefore, I want to carefully choose a physical therapy. I heard there is a method called Lipp (I’m not sure if the characters are correct), which reduces inflammation without damaging the cervix. I would like to ask the doctor if this procedure will affect future vaginal delivery? Are there any precautions to take?First follow-up question: I mainly want to know a physical therapy that can cure erosion in one session without affecting future vaginal delivery. I have tried medication, but the results have always been unsatisfactory. Could any doctors tell me if the Lipp has this effect (only to remove inflammation)?
Doctor's answer:
Physical therapy: This is a widely used treatment method that offers the advantages of a short course and good efficacy. It is suitable for patients with large areas of erosion and deep inflammatory infiltration. Common methods include electrocautery, laser therapy, and cryotherapy. Electrocautery is best performed 3 to 7 days after the end of menstruation. During treatment, the electrocautery head is applied to the eroded area with slight pressure, moving back and forth from the inside out, until slightly beyond the erosion. Postoperatively, a 1% gentian violet solution is applied to the wound. Patients may experience increased vaginal discharge for 2 to 3 days, and slight vaginal bleeding may occur within 2 weeks. After 2 to 3 weeks, the wound will slough off, and squamous epithelial healing will begin.Laser therapy uses a laser to carbonize and form a scab on the eroded tissue. About 3 weeks postoperatively, the scab will fall off, and new squamous epithelium will grow in the wound. After laser treatment, there is also significant vaginal discharge.
Cryotherapy uses liquid nitrogen as a cooling source, employing rapid cooling devices to freeze, necrose, and detach the eroded tissue. Postoperatively, there is minimal bleeding, but vaginal discharge is more abundant, usually lasting 2 to 3 weeks. Necrotic tissue will fall off after 6 weeks, and the wound will heal by 8 weeks.
Before physical therapy surgery, the external genitalia, vagina, and cervix must be routinely disinfected. Postoperatively, due to the large amount of discharge, it is important to maintain cleanliness and dryness of the external genitalia to prevent infection. Sexual activity, tub baths, and vaginal irrigation should be avoided until the wound is fully healed, which typically takes 4 to 8 weeks. Monthly follow-up examinations are recommended to monitor wound healing after treatment.
Surgical treatment: If the above treatments are ineffective, or if there is cervical hypertrophy, or if the erosion is deep and extensive, involving the cervical canal, cervical conization or total hysterectomy may be considered. However, surgical treatment is rarely used today.