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SAINT-PETERSBURG – 2010 - page 39 / 128

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changes in the genitals’ mucous membrane. In association with the ovaries function fall-out, the blood supply becomes rather worse, elasticity of the sex organs’ mucous membrane becomes reduced, the rhythm of epithelium desquamation disappears, production of mucus sharply drops due to metaplasia and changes in the cylindrical epithelium structure, the vaginal microbiocenosis becomes disturbed, and the physiological protection of the vaginal epithelium and endocervix becomes much lower. These factors provide for appearance of favourable conditions for exogenous opportunistic pathogenic bacteria and for activation of the endogenous those. The reduction of the protection factors in the postmenopause prompts the persistence of infection.

Diagnostics of the cervix of the uterus chronic inflammatory diseases, particularly of the cervical canal, is quite complicated. In fact, the existing endocervicitis is due to penetration of microorganisms to the intercellular space of the mucous membrane crypts against the background of occurring metaplasia which makes the infectious factor less accessible for diagnostics and sanitation [3].

The main techniques of assessment of the cervix of the uterus condition involve visual examination with the aid of gynaecological mirror and colposcope, as well as microbiological and oncocytological study of the material obtained from ecto- and endocervix. Also assessment of junction of different types of the epithelium, revealing of the background pathological condition (inflammation, dyskeratosis), and diagnostics of cervical intraepithelial dysplasia are important.  A screening technique for revealing CU cancer involves oncocytological study. To verify the pathogenic agent in inflammation, bacterioscopic, bacteriological and molecular-biological techniques are used.  

The cervical canal relates to the so called “mute” zone of diagnostics because of practical inaccessibility for its study in its upper 2/3. The assessment of the cervical canal condition is made more difficult by obliterating processes associated with some past inflammation, or diathermic-surgical methods of treatment, or age-specific changes. Diagnostic curettage of the cervical canal relates to invasive method often quite difficult to perform and insufficiently informative by many positions. A

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