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Cervical Stenosis
Christine O. Menias, MD; Sandra J. Allison, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Cervical canal narrowing from benign or iatrogenic source
              • When severe, results in hydrometra, pyometra, or hematometra
            • Defined as inability to pass 2.5-4.5 mm probe through cervical os

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Jain D: An unusual case of secondary amenorrhoea. BMJ Case Rep. 2013, 2013
                                    2. Noor C et al: An unusual case of hematometra in a postmenopausal woman associated with Manchester repair. J Low Genit Tract Dis. 16(2):162-4, 2012
                                    3. Cicchiello LA et al: Ultrasound evaluation of gynecologic causes of pelvic pain. Obstet Gynecol Clin North Am. 38(1):85-114, viii, 2011
                                    4. Walid MS et al: An invisible stenotic cervix. Arch Gynecol Obstet. 283 Suppl 1:121-2, 2011
                                    5. Opolskiene G et al: Three-dimensional ultrasound imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding and sonographic endometrial thickness of at least 4.5 mm. Ultrasound Obstet Gynecol. 35(1):94-102, 2010
                                    6. Borgatta L et al: Cervical obstruction complicating second-trimester abortion: treatment with misoprostol. Obstet Gynecol. 113(2 Pt 2):548-50, 2009
                                    7. Diedrich J et al: Complications of surgical abortion. Clin Obstet Gynecol. 52(2):205-12, 2009
                                    8. Steinkeler JA et al: Female infertility: a systematic approach to radiologic imaging and diagnosis. Radiographics. 29(5):1353-70, 2009
                                    9. Christianson MS et al: Overcoming the challenging cervix: techniques to access the uterine cavity. J Low Genit Tract Dis. 12(1):24-31, 2008
                                    10. Grund D et al: A new approach to preserve fertility by using a coated nitinol stent in a patient with recurrent cervical stenosis. Fertil Steril. 87(5):1212, 2007
                                    11. McCausland AM et al: Long-term complications of endometrial ablation: cause, diagnosis, treatment, and prevention. J Minim Invasive Gynecol. 14(4):399-406, 2007
                                    12. Tan Y et al: Urinary catheter stent placement for treatment of cervical stenosis. Aust N Z J Obstet Gynaecol. 47(5):406-9, 2007
                                    13. Van den Bosch T et al: A thin and regular endometrium on ultrasound is very unlikely in patients with endometrial malignancy. Ultrasound Obstet Gynecol. 29(6):674-9, 2007
                                    14. Debby A et al: Intra-uterine fluid collection in postmenopuasal women with cervical stenosis. Maturitas. 55(4):334-7, 2006
                                    15. Hammoud AO et al: Ultrasonography-guided transvaginal endometrial biopsy: a useful technique in patients with cervical stenosis. Obstet Gynecol. 107(2 Pt 2):518-20, 2006
                                    16. Newman C et al: Hysterectomy in women with cervical stenosis. Surgical indications and pathology. J Reprod Med. 48(9):672-6, 2003
                                    17. Houlard S et al: Risk factors for cervical stenosis after laser cone biopsy. Eur J Obstet Gynecol Reprod Biol. 104(2):144-7, 2002
                                    18. Ohara N: Acute onset of hematometra associated with endometritis and cervical stenosis. A case report. Clin Exp Obstet Gynecol. 29(1):23-4, 2002
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Definitions

                                              • Cervical canal narrowing from benign or iatrogenic source
                                                • When severe, results in hydrometra, pyometra, or hematometra
                                              • Defined as inability to pass 2.5-4.5 mm probe through cervical os

                                            IMAGING

                                            • General Features

                                              • CT Findings

                                                • MR Findings

                                                  • Ultrasonographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Jain D: An unusual case of secondary amenorrhoea. BMJ Case Rep. 2013, 2013
                                                                      2. Noor C et al: An unusual case of hematometra in a postmenopausal woman associated with Manchester repair. J Low Genit Tract Dis. 16(2):162-4, 2012
                                                                      3. Cicchiello LA et al: Ultrasound evaluation of gynecologic causes of pelvic pain. Obstet Gynecol Clin North Am. 38(1):85-114, viii, 2011
                                                                      4. Walid MS et al: An invisible stenotic cervix. Arch Gynecol Obstet. 283 Suppl 1:121-2, 2011
                                                                      5. Opolskiene G et al: Three-dimensional ultrasound imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding and sonographic endometrial thickness of at least 4.5 mm. Ultrasound Obstet Gynecol. 35(1):94-102, 2010
                                                                      6. Borgatta L et al: Cervical obstruction complicating second-trimester abortion: treatment with misoprostol. Obstet Gynecol. 113(2 Pt 2):548-50, 2009
                                                                      7. Diedrich J et al: Complications of surgical abortion. Clin Obstet Gynecol. 52(2):205-12, 2009
                                                                      8. Steinkeler JA et al: Female infertility: a systematic approach to radiologic imaging and diagnosis. Radiographics. 29(5):1353-70, 2009
                                                                      9. Christianson MS et al: Overcoming the challenging cervix: techniques to access the uterine cavity. J Low Genit Tract Dis. 12(1):24-31, 2008
                                                                      10. Grund D et al: A new approach to preserve fertility by using a coated nitinol stent in a patient with recurrent cervical stenosis. Fertil Steril. 87(5):1212, 2007
                                                                      11. McCausland AM et al: Long-term complications of endometrial ablation: cause, diagnosis, treatment, and prevention. J Minim Invasive Gynecol. 14(4):399-406, 2007
                                                                      12. Tan Y et al: Urinary catheter stent placement for treatment of cervical stenosis. Aust N Z J Obstet Gynaecol. 47(5):406-9, 2007
                                                                      13. Van den Bosch T et al: A thin and regular endometrium on ultrasound is very unlikely in patients with endometrial malignancy. Ultrasound Obstet Gynecol. 29(6):674-9, 2007
                                                                      14. Debby A et al: Intra-uterine fluid collection in postmenopuasal women with cervical stenosis. Maturitas. 55(4):334-7, 2006
                                                                      15. Hammoud AO et al: Ultrasonography-guided transvaginal endometrial biopsy: a useful technique in patients with cervical stenosis. Obstet Gynecol. 107(2 Pt 2):518-20, 2006
                                                                      16. Newman C et al: Hysterectomy in women with cervical stenosis. Surgical indications and pathology. J Reprod Med. 48(9):672-6, 2003
                                                                      17. Houlard S et al: Risk factors for cervical stenosis after laser cone biopsy. Eur J Obstet Gynecol Reprod Biol. 104(2):144-7, 2002
                                                                      18. Ohara N: Acute onset of hematometra associated with endometritis and cervical stenosis. A case report. Clin Exp Obstet Gynecol. 29(1):23-4, 2002