Cervical ectropion

You have been told you have a condition called cervical ectropion (previously known as cervical erosion). This leaflet explains the following.

• What the condition is.

• What the signs and symptoms are.

• The treatments available.

• What to do after surgery.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

What is cervical ectropion?

Cervical ectropion is related to the hormone oestrogen. It is common in:

• young women

• pregnant women, and

• those taking the oral combined contraceptive pill.

What are the signs and symptoms?

Most patients have no symptoms. However, a few patients notice:

• an increased vaginal discharge; or

• unexplained vaginal bleeding, which may occur between periods or after sex.

Some patients may bleed when they have a cervical cytology test (smear).

How is the condition diagnosed?

Before starting treatment, your doctor will rule out:

• infection

• inflammation, and

• any possibility of abnormality.

This may mean you need to have cervical swabs taken. Some patients will also need a cervical biopsy.

What are the treatment options?

In most cases treatment is not needed, as ectropion is a normal variant on the cervix. Also, as the condition is a natural one, ectropion will often re-develop after we have treated it.

However we can treat the condition, if you have had tests to rule out the above and your symptoms are still causing you trouble.

A decision to treat your ectropion will depend on:

• any tests your GP has recently performed; or

• any investigations performed at the hospital.

We can treat ectropion with cautery, using one of the following procedures.

• Diathermy (under local anaesthetic)

• Cryocautery

• Silver nitrate

For each treatment we will ask you to lie on a couch with your legs supported. We will insert an instrument called a speculum into your vagina to allow us to see your cervix. A speculum is the instrument used when you have a smear.

Before your procedure, you will discuss with your doctor the type of treatment you will have. Please use this time to ask any questions. Remember, you can withdraw your consent for treatment at any time.

• Cautery using diathermy

  Your doctor will inject local anaesthetic into your cervix, to numb the area. They use an instrument called a coagulation ball to cauterise the top layer of cells on your cervix using an electric current.

  You may have a slight bloody, watery discharge for up to 2 weeks. Use sanitary pads and not tampons during this time, to help reduce the risk of infection. You may wish to avoid sex until the discharge has settled.

  Once the local anaesthetic has worn off, you may have period-like pain. Take whichever pain relief you normally use for this, such as paracetamol.

• Cryocautery

  Cryocautery is a freezing technique used to treat ectropion. Your doctor places a small probe with a metal tip onto your cervix or they treat your cervix with a cold spray. The treatment lasts approximately 90 seconds. You may have some period-like pains during this time. Local anaesthetic is not needed. If the period-like pains continue at home, take your normal pain relief such as paracetamol.

  You may have a heavy, watery discharge for approximately 2 weeks. Use sanitary pads and not tampons during this time, to help reduce the risk of infection. If the discharge is yellow or smells bad, please tell your GP who can prescribe antibiotics. You may wish to avoid sex until the discharge has settled.

• Cautery using silver nitrate

  Silver nitrate is a chemical stick that we apply to the ectropion, which cauterises the area. The procedure takes approximately 1 to 2 minutes. It is not used on large areas. Local anaesthetic is not needed.

  You may get some watery, black discharge for up to 1 week. This will stain your underwear. Use sanitary pads and not tampons during this time, to help reduce the risk of infection. You may wish to avoid sex until the discharge has settled. Use a condom if you have sex, as the silver nitrate on the cervix may burn your partner.

What are the risks / side effects of treatment?

• In some cases, the treated cervix may become infected. If the discharge becomes particularly heavy, with a bad smell contact your GP for investigation and treatment.

• There is a small risk of bleeding, which may occur during the procedure and is easily controlled.

• For some patients, symptoms do not improve. These patients may need further assessment.

Will I have to stay in hospital?

No. We perform each treatment as a day case procedure (you can go home afterwards).

What happens if I decide not to have treatment?

You may decide that you do not wish to have treatment. If so, the delicate skin on your cervix will gradually change to thicker skin. How long this takes will vary between patients.

You may continue to have symptoms, but you will come to no harm. It is important that you go for cervical screening when contacted by your GP surgery.

What if I have any questions or concerns?

If you have any questions, please contact one of the following.

• Colposcopy Unit, Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 783107 (Monday to Friday; 8am to 5pm)

• Colposcopy Suite, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 234585 (Monday to Thursday; 8am to 5pm)
  Outside of these times an answer machine is available for you to leave a message.

• For urgent enquiries, please contact one of the following where a nurse will be able to advise you.

  • Birchington Ward
    Telephone: 01843 234201

  • Women’s Health Suite
    Telephone: 01233 651987

References / sources of evidence

• Cambridge University Hospitals NHS Foundation Trust. Cervical Ectropion patient leaflet.

• NHS England: Cervical screening: programme overview.

• Shafi M, Nazeer S (2012). Colposcopy a practical guide. 2nd edition. Cambridge University Press: Cambridge.

We have used the term ‘women’ in this leaflet. When we use this term we also mean people with female reproductive organs who do not identify as a woman. East Kent Hospitals is committed to supporting people of all gender identities. Please tell your doctor or nurse how you would like them to address you, so we can be sure to get this right.

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

What do you think of this leaflet?

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• Patient Voice Team
  Telephone: 01227 868605
  Email