Stenosis of the uterine cervix

Stenosis of the uterine cervix is the pathologic narrowing of the uterine cervix. The term cervical stenosis is clinically defined as cervical narrowing that prevents the insertion of a 2.5 mm wide dilator.

If the stenosis is severe enough it may result in proximal obstruction resulting in:

  • haematometra: women of childbearing age with cervical stenosis are less likely to show evidence of haematometra than postmenopausal patients
  • hydrometra 
  • pyometra

Other potential consequences include:

  • infertility 2
  • impediment to assisted fertility techniques 
    • embryo transfer
    • intra-uterine insemination
Aetiology

It can result from many causes which include:

Hysterosalpingogram

May appear as narrowing of the endocervical canal (normal diameter: 0.5-3.0 cm), or it may manifest as complete obliteration of the cervical os, preventing insertion of the hysterosalpingographic catheter.

Ultrasound

Although it is difficult on imaging to the directly visualise the stenosis, visualisation of an underlying mass in the appropriate location may suggest an accompanying stenosis especially if it is complicated by proximal dilatation of the female genital tract (see complications).

In selected situations, gradual dilatation of the cervix, often performed with ultrasound guidance, can be an effective treatment.

General considerations include:

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Article Information

rID: 13334
Tag: cases
Synonyms or Alternate Spellings:
  • Cervical stenosis (pelvis)
  • Uterine cervical stenosis

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