Stenosis Of Uterine Cervix

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Cervical stenosis means that the opening in the cervix (the endocervical canal) is more narrow than is typical. In some cases, the endocervical canal may be completely closed. A stenosis is any passage in the body that is more narrow than it should typically be.
Not to be confused with cervical spinal stenosis.
Symptoms depend on whether the cervical canal is partially or completely obstructed and on the patient's menopausal status. Pre-menopausal patients may have a build up of blood inside the uterus which may cause infection, sporadic bleeding, or pelvic pain. Patients also have an increased risk of infertility and endometriosis.[1]
Cervical stenosis may impact natural fertility by impeding the passage of sperm into the uterus. In the context of infertility treatments, cervical stenosis may complicate or prevent the use of intrauterine insemination (IUI) or in vitro fertilization (IVF) procedures.[2]
Cervical stenosis may be present from birth or may be caused by other factors:
Treatment of cervical stenosis involves opening or widening the cervical canal. The condition may improve on its own following the vaginal delivery of a baby.[4] Cervical canal widening can be temporarily achieved by the insertion of dilators into the cervix. If the stenosis is caused by scar tissue, a laser treatment can be used to vaporize the scarring.[5] Finally, the surgical enlargement of the cervical canal can be performed by hysteroscopic shaving of the cervical tissue.[6]
^ a b c The Merck Manual Home Edition. Last full review/revision December 2008 by S. Gene McNeeley. Cervical Stenosis
^ Pabuccu R; Ceyhan ST; Onalan G; Goktolga U; Ercan CM; Selam B (Sep–Oct 2005). "Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series". Journal of Minimally Invasive Gynecology. 12 (5): 436–8. doi:10.1016/j.jmig.2005.06.003. PMID 16213431.
^ a b c d "Cervical Stenosis". Health Science Report. Alotek Supplement Company. Retrieved 2007-02-10.
^ "Dysmenorrhoea". Health24. Media24 (Naspers) Group. Retrieved 2007-02-10.
^ Baggish MS; Baltoyannis P (July 1987). "Carbon dioxide laser treatment of cervical stenosis". Fertility and Sterility. 48 (1): 24–8. PMID 3595913.
^ Noyes, N (May 1999). "Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization". Fertility and Sterility. 71 (5): 965–6. doi:10.1016/S0015-0282(99)00097-7. PMID 10231067.
Congenital malformation of female reproductive organs
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Last full review/revision Mar 2021| Content last modified Mar 2021
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Cervical stenosis is narrowing of the passageway through the cervix (the lower part of the uterus).
Cervical stenosis often causes no symptoms.
Rarely, the uterus fills with blood or pus.
The opening of the cervix can be widened to relieve symptoms.
In cervical stenosis, the passageway through the cervix (from the vagina to the main body of the uterus) is narrow or completely closed.
Cervical stenosis usually results from a disorder or another condition, such as the following:
Menopause, because the tissues in the cervix thin (atrophy)
Cancer of the cervix or cancer of the lining of the uterus (endometrial cancer)
Surgery that involves the cervix—for example, done to treat precancerous changes of the cervix (dysplasia)
Procedures that destroy or remove the lining of the uterus (endometrial ablation) in women who have persistent vaginal bleeding
Radiation therapy to treat cervical cancer or endometrial cancer
In women who are still menstruating, menstrual blood mixed with cells from the uterus may flow backward into the pelvis, possibly causing endometriosis.
Rarely, cervical stenosis results in an accumulation of blood in the uterus (hematometra).
The Uterus, Cervix, and Cervical Canal
Also rarely, pus accumulates in the uterus, particularly if the cause of stenosis is cervical or endometrial cancer. Accumulation of pus in the uterus is called pyometra.
Cervical stenosis often causes no symptoms.
Before menopause, cervical stenosis may cause menstrual abnormalities, such as no periods (amenorrhea ), painful periods (dysmenorrhea ), and abnormal bleeding . Sometimes cervical stenosis causes infertility because sperm cannot pass through the cervix to fertilize the egg.
A hematometra or pyometra can cause pain or cause the uterus to bulge. Sometimes women feel a lump in the pelvic area.
Doctors may suspect the diagnosis based on symptoms and circumstances, such as the following:
When periods stop or become painful after surgery on the cervix
When doctors cannot insert an instrument into the cervix for another test—for example, to obtain a sample of tissue from the cervix for a Papanicolaou (Pap) or human papilloma virus (HPV) test (called cervical cytology testing) or a sample from the lining of the uterus for an endometrial biopsy
Doctors confirm the diagnosis by trying to pass a probe through the cervix into the uterus.
If cervical stenosis causes symptoms, tests are done to rule out cancer. If premenopausal women have a hematometra or pyometra, these tests may include cervical cytology testing (such as a Pap or HPV test) and endometrial biopsy . Before these tests can be done, doctors do a procedure—called dilation and curettage (D & C) widen or open the cervix. This procedure enables doctors to take samples from the cervix and from the lining of the uterus for testing.
No further tests are needed if all of the following apply:
Women are postmenopausal (menstrual periods have stopped).
They have no symptoms and no hematometra or pyometra.
Results of cervical cytology tests are normal.
Cervical stenosis is treated only if women have symptoms, a hematometra, or a pyometra. Then, the cervix may be widened (dilated) by inserting small, lubricated metal rods (dilators) through its opening, then inserting progressively larger dilators. To try to keep the cervix open, doctors may place a tube (cervical stent) in the cervix for 4 to 6 weeks.
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Miscellaneous Gynecologic Abnormalities
Introduction to Miscellaneous Gynecologic Abnormalities
Inclusion and Epidermal Cysts of the Vulva
Abortion is defined as the intentional ending of a pregnancy by surgery or drugs. Which of the following statements about abortion in the United States is most accurate? 
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