CERVICAL POLYPI; HYPERTROPHIC ELONGATION OF THE CERVIX; CHANCRE OF
THE CERVIX; TUBERCULOSIS OF THE CERVIX.
=Cervical Polypi.=--Polypoid tumors are found growing from the mucous
membrane of the cervical canal, projecting into the canal or protruding
from the external os. The mucous polypus is the most usual form, and is
caused by cystic degeneration of the Nabothian glands of the cervical
mucous membrane. Sometimes such polypi protrude from the ostium vaginæ.
Less often a papillary or warty growth is found on the mucous membrane
of the cervical canal, in the neighborhood of the external os. There is
usually present dilatation of the external os and cervical canal. The
symptoms of cervical polypi are not characteristic. Inflammation of the
cervical mucous membrane and cervical catarrh may result. There may be
slight, and rarely profuse, bleeding from the external os. The bleeding
may follow efforts at straining, sexual connection, long standing, or
exercise. Occurring at the time of the menopause or later, this symptom
would excite the suspicion of beginning cancer of the cervix.
Pediculated polypi should be twisted or cut away. Bleeding is usually
very slight. The sessile growths, like the papillomata, should be
excised, the incision being carried well below the base of the tumor
into the healthy tissue of the cervix. The wound may then be closed
with an interrupted suture. In every case of such tumor a careful
microscopical examination should be made to determine its benign or
malignant character.
=Hypertrophic Elongation of the Vaginal Cervix.=--In this condition
there is a marked increase in the length of the vaginal portion of the
cervix uteri, though the thickness of the cervix may be but little, if
any, greater than normal. The vaginal cervix may be so long that the
external os may lie outside the ostium vaginæ.
[Illustration: FIG. 112.--Mucous polyp of cervix.]
[Illustration: FIG. 113.--Cervical polyp.]
The condition is a true hypertrophic growth, the cause of which is
unknown. It is probably congenital, as it is found in the virgin.
The diagnosis between elongation of the vaginal cervix and the various
forms of prolapse of the uterus and the vagina may be readily made.
In elongation of the vaginal cervix the fundus uteri is at the normal
level; there is no inversion of the vagina; the vaginal fornices are in
the normal position.
Elongation of the vaginal cervix to a degree sufficient to be
considered pathological is very rare.
The treatment consists in amputation of the cervix.
=Chancre of the Cervix.=--Chancre of the cervix is a rare lesion. One
observer, Rassennone, found 117 uterine chancres in a series of 1375
cases of venereal sores on the female genitals. The sore may occur on
either lip of the cervix and may extend into the cervical canal. The
appearance is that characteristic of similar sores in other parts of
the body.
The diagnosis may be made from a history of coitus with a man having
active syphilis, by microscopic examination if necessary, and by the
later appearance of secondary syphilitic symptoms.
=Tuberculosis of the Cervix.=--Tuberculosis of the cervix is a very
rare condition. The appearance of the cervix in such cases resembles
that of cancer. In fact, hysterectomy has been performed for this
condition under the mistaken diagnosis of malignant disease.
The diagnosis may be made by the microscopic examination of the
discharge and of excised tissue.
Complete hysterectomy should be performed for tuberculosis of the
cervix.