Cervical stenosis is stricture of the internal cervical os.
Cervical stenosis may be congenital or acquired.
The most common acquired causes of cervical stenosis are
Cervical stenosis may be complete or partial.
It may result in the following:
Cervical stenosis may be suspected based on symptoms and signs (particularly development of amenorrhea or dysmenorrhea after cervical surgery) or on inability to obtain endocervical cells or an endometrial sample for diagnostic tests (eg, for a Papanicolaou [Pap] test).
Diagnosis of complete stenosis is established if a 1- to 2-mm diameter probe cannot be passed into the uterine cavity.
If cervical stenosis causes symptoms or uterine abnormalities (eg, hematometra, pyometra), cervical cytology and endometrial biopsy or D & C should be done to exclude cancer. For postmenopausal women with no history of abnormal Pap tests and for women without symptoms or uterine abnormalities, no further evaluation is needed.
Cervical stenosis may be congenital or acquired (eg, caused by menopause, cervical surgery, endometrial ablation, cervical or uterine cancer, or radiation therapy).
Cervical stenosis can cause amenorrhea, dysmenorrhea, abnormal bleeding, and infertility in premenopausal women; postmenopausal women may be asymptomatic for long periods of time.
Suspect cervical stenosis based on symptoms and signs or on inability to obtain endocervical or endometrial samples for tests; inability to pass a 1- to 2-mm diameter probe into the uterine cavity confirms complete stenosis.
If symptoms or uterine abnormalities (eg, hematometra, pyometra) are present, exclude cancer by cervical cytology and endometrial biopsy or D & C, then dilate the cervix and place a stent.