Machado Junior Luís Carlos, Dalmaso Ana Sílvia Whitaker, Carvalho Heráclito Barbosa de
Centro de Saúde Escola Samuel Barnsley Pessoa, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2008 Mar 6;126(2):132-9. doi: 10.1590/s1516-31802008000200014.
Uterine cervical ectopy (cervical erosion) is today considered to be a physiological condition, but there still seems to be a strong tendency towards treating it. The purpose of this study was to review the medical literature for evidence regarding benefits from treating cervical ectopy.
The following databases were reviewed: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Cochrane Library databases. In addition, six medical textbooks were consulted.
The review showed that: 1) there is probably an association between ectopy and higher risk of Chlamydia trachomatis, human papillomavirus and human immunodeficiency virus infection; 4) there is probably an association between ectopy and cervical intraepithelial neoplasia; 5) there is an association between ectopy and mucous discharge and nocturia; and 6) there is no evidence of an association between ectopy and cervical cancer, or of protection against cervical cancer associated with ectopy treatment.
子宫颈外翻(宫颈糜烂)如今被认为是一种生理状况,但对其进行治疗的倾向似乎仍然很强。本研究的目的是查阅医学文献,寻找有关治疗宫颈外翻益处的证据。
查阅了以下数据库:医学文献分析与检索系统在线数据库(Medline)、医学文摘数据库(Embase)、拉丁美洲及加勒比卫生科学文献数据库(Lilacs)和Cochrane图书馆数据库。此外,还查阅了六本医学教科书。
综述表明:1)外翻可能与沙眼衣原体、人乳头瘤病毒和人类免疫缺陷病毒感染的较高风险相关;4)外翻可能与宫颈上皮内瘤变相关;5)外翻与白带增多和夜尿症相关;6)没有证据表明外翻与宫颈癌之间存在关联,也没有证据表明外翻治疗可预防宫颈癌。
1)医学文献中未发现支持常规治疗外翻的数据;2)可以推荐进行治疗以缓解症状,但归因于外翻的症状比在对照研究中所能证实的更多;3)有必要进行进一步研究,以检验外翻治疗可预防宫颈癌这一假设。