Cervical stenosis is narrowing of the passageway through the cervix (the lower part of the uterus).
In cervical stenosis, the passageway through the cervix (from the vagina to the main body of the uterus) is narrow or completely closed.
Some women are born with cervical stenosis. In others, cervical stenosis results from a disorder or another condition, such as the following:
Cervical stenosis may result in an accumulation of blood in the uterus (hematometra). In women who are still menstruating, menstrual blood mixed with cells from the uterus may flow backward into the pelvis, possibly causing endometriosis (see Endometriosis). If pus forms in the uterus (as it may in women with cervical or endometrial cancer), pus may accumulate in the uterus. Accumulation of pus in the uterus is called pyometra.
Before menopause, cervical stenosis may cause menstrual abnormalities, such as no periods (amenorrhea), painful periods (dysmenorrhea), and abnormal bleeding. Cervical stenosis can also cause infertility because sperm cannot pass through the cervix to fertilize the egg.
After menopause, cervical stenosis may be present but not cause symptoms.
A hematometra or pyometra can cause pain or cause the uterus to bulge. Sometimes women feel a lump in the pelvic area.
Doctors suspect the diagnosis based on symptoms and circumstances, such as the following:
Doctors confirm the diagnosis by trying to pass a probe through the cervix into the uterus.
No further tests are needed for the following:
If cervical stenosis causes symptoms, a hematometra, or a pyometra, tissue samples are taken and examined under a microscope to rule out cancer. After treatment (which widens the cervix), doctors take samples from the cervix and from the uterine lining.
Cervical stenosis is treated only if women have symptoms, a hematometra, or a pyometra. Then, the cervix may be widened (dilated) by inserting small, lubricated metal rods (dilators) through its opening, then inserting progressively larger dilators. To try to keep the cervix open, doctors may place a tube (cervical stent) in the cervix for 4 to 6 weeks.
Last full review/revision December 2008 by S. Gene McNeeley, MD