Merck Manual

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Cervical Stenosis

By

Charlie C. Kilpatrick

, MD, MEd, Baylor College of Medicine

Medically Reviewed Mar 2021 | Modified Sep 2022
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Topic Resources

Cervical stenosis is narrowing of the passageway through the cervix (the lower part of the uterus).

  • Cervical stenosis often causes no symptoms.

  • Rarely, the uterus fills with blood or pus.

  • The opening of the cervix can be widened to relieve symptoms.

In cervical stenosis, the passageway through the cervix (from the vagina to the main body of the uterus) is narrow or completely closed.

Cervical stenosis usually results from a disorder or another condition, such as the following:

Rarely, cervical stenosis results in an accumulation of blood in the uterus (hematometra).

The Uterus, Cervix, and Cervical Canal
VIDEO

Also rarely, pus accumulates in the uterus, particularly if the cause of stenosis is cervical or endometrial cancer. Accumulation of pus in the uterus is called pyometra.

Symptoms of Cervical Stenosis

Diagnosis of Cervical Stenosis

  • A doctor's evaluation

  • Sometimes tests to rule out cancer

Doctors may suspect the diagnosis based on symptoms and circumstances, such as the following:

  • When periods stop or become painful after surgery on the cervix

  • When doctors cannot insert an instrument into the cervix for another test—for example, to obtain a sample of tissue from the cervix for a Papanicolaou (Pap) or human papilloma virus (HPV) test (called cervical cytology testing) or a sample from the lining of the uterus for an endometrial biopsy

Doctors confirm the diagnosis by trying to pass a probe through the cervix into the uterus.

No further tests are needed if all of the following apply:

  • Women are postmenopausal (menstrual periods have stopped).

  • They have no symptoms and no hematometra or pyometra.

  • Results of cervical cytology tests are normal.

Treatment of Cervical Stenosis

  • Widening of the cervix

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.

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