Cervical stenosis

Definition

• Cervical stenosis is a narrowing or occlusion (stricture) of the internal cervical os.

Aetiopathogenesis

Aetiology and risk factors

• The most common acquired causes include the menopause and cervical or uterine cancer.

Clinical features

• Cervical stenosis is usually asymptomatic; before the menopause, amenorrhoea, dysmenorrhoea, abnormal bleeding and, rarely, infertility may occur.
• After the menopause, women may remain asymptomatic for long periods.
• Consequences include haematometra with pelvic pain or dysmenorrhoea, retrograde menstrual flow with possible endometriosis in premenopausal women, and pyometra, particularly with cervical or uterine cancer.

Diagnosis

• Stenosis is often noticed when instruments are difficult to introduce into the cervical canal and uterine cavity; new amenorrhoea or dysmenorrhoea after a cervical procedure is suspicious.
• Complete stenosis is established if a 1–2 mm diameter probe cannot be passed into the uterine cavity.
• Haematometra or pyometra may cause uterine distension, sometimes with a palpable mass.

Keep learning in the app

Further reading (selection)

1. MSD Manual Professional Edition: Cervical Stenosis

Cross-references