Cause and effect of injury to the cervix

Cause of injury

Inflammatory changes in the cervix occur as a result of physical or chemical damage to the cervical mucosa. Inflammatory changes also occurs as result of cervical infection with a variety of microorganisms which may kill the cells directly or indirectly through toxins and enzymes.

Physical or chemical injury	Child birth Abortion Douching Radiation Laser ablation Electrocautery
Infectious organisms	Viruses Herpes genitalis, cytomegalovirus, human papillomavirus Bacteria Streptococci, staphylococci, chlamydial organisms, N gonorrhoea, M.tuberculosis, Actinomyces sp Fungal agents Candida albicans, Protozoa Trichomonas vaginalis, schistosoma s

Effects of injury

Injury to the  cervical epithelium results in an inflammatory response which is charcterised by:

• Localised damage to the epithelial cells characterised by degenerative changes to the cytoplasm of the cells  and coagulative necrosis of the nuclei
• Systemic changes in the underlying stroma (the inflammatory response).These involve:
  1. hyperaemia of the papillary vessels
  2. exudation of fluid into the surrounding tissue
  3. migration of polymorphs to the site of infection or injury

These changes  are non specific and occur regardless of the cause of the injury or infection and can be  recognised in histological sections of non specific cervicitis.