The cervix is the small organ located at the bottom of the uterus, which opens into the vaginal canal. Cervical stenosis is a condition in which the cervix narrows or completely closes off, hindering or blocking the passage between the uterus and the vaginal canal.
What Causes Cervical Stenosis?
Cervical stenosis can exist at birth as a result of a genetic condition, or it can develop from other conditions or procedures, such as:
- Cervical cancer
- Cervical cysphasi
- Uterine cancer
- Endometrial cancer
- Radiation therapy for cervical or endometrial cancers
- Surgical procedures on the cervix, such as surgery to treat dysplasia (precancerous cervical cell changes)
- Surgeries that affect the uterine lining, such as an endometrial ablation
- History of Leep or CKC
- History of multiple D & Cs
- Cervical/vaginal atrophy due to menopause
- Postmenopausal vaginal dryness
Complications from Cervical Stenosis
Complications due to cervical stenosis may arise and include:
A hematometra forms when blood is unable to properly flow through the cervix, and accumulates in the uterus. The buildup of blood can lead to inflammation and other complications.
This is an accumulation of pus in the uterus. This condition usually affects women who have cervical stenosis as a result of endometrial or cervical cancer.
Cervical Stenosis Symptoms
For some women, especially women who have reached menopause, cervical stenosis may have few or no symptoms. However, cervical stenosis may be associated with:
- Irregular periods and abnormal bleeding
- No periods (amenorrhea)
- Pain during your period (dysmenorrhea)
- Infertility, if the stenosis is completely blocking the sperm’s path to the uterus
- Chronic pelvic pain or bulging in the pelvic area (occurs with pyometra and hematometra)
Diagnosing Cervical Stenosis
Your OB-GYN may suspect cervical stenosis if you’re experiencing some of the above symptoms, especially after cervical or uterine surgery. Sometimes stenosis is suspected when your doctor has difficulty collecting a sample for a routine Pap or HPV test, or difficultly performing an endometrial biopsy. Your doctor can diagnose the problem by attempting to insert a slender instrument through the cervix.
If you are diagnosed with cervical stenosis, your OB-GYN may want to conduct tests to rule out cervical and endometrial cancers. In order to take a biopsy of your uterine lining, the doctor will need to open the cervix with medication or a procedure called dilation and curettage (also known as a D&C).
Cervical Stenosis Treatment
Your OB-GYN can treat cervical stenosis by physically widening the cervix with instruments called dilators. Dilators are thin, lubricated rods that come in progressively larger sizes, which can be inserted one by one until the appropriate dilation has been reached. In some cases, the doctor will then insert a cervical stent, which is a tube that can keep the cervix from re-closing. The stent may remain in the cervix for 4-6 weeks.