Cervical dysplasia of the 2nd degree treatment. How is cervical dysplasia treated? Cervical dysplasia - symptoms and signs
Content
This is one of the most dangerous gynecological diseases that can provoke the development of cancer. Only through timely diagnosis and correctly chosen treatment tactics can cancer be prevented and the health of a woman’s genital organs restored. Cervical dysplasia is always accompanied by changes in the epithelium at the cellular level, and manifests itself as symptoms, as a rule, only in advanced stages of the disease. This disease does not have a specific clinical picture, often masquerading as other gynecological pathologies.
What is cervical dysplasia
This diagnosis refers to atypical changes in the epithelium of the cervical mucosa in its vaginal part, which are defined as precancerous processes. At the beginning of its development, dysplasia is an irreversible pathology, so its timely diagnosis and treatment is a reliable way to prevent the occurrence of cancer. Unlike cervical erosion, which appears when mechanical tissue injuries occur, dysplasia affects the cellular structures of the organ’s mucosa.
Symptoms
For a long time, the symptoms of the disease do not make themselves felt. As a rule, the patient learns about structural disorders of the squamous epithelium by chance during a routine examination by a gynecologist. Signs that you should visit a doctor include:
- burning, itching in the vagina;
- vaginal discharge with an unpleasant odor;
- blood impurities in mucous secretions;
- pain, discomfort during sexual intercourse;
- temperature increase;
- pulling sensations in the lower part of the peritoneum (rare symptom).
Causes
Often, the development of the disease is observed in patients with the presence of oncogenic type HPV (HPV-18 and HPV-16). With prolonged presence in the body and squamous epithelial cells, the papillomavirus causes serious changes in their structure - dysplasia. Certain aggravating background factors contribute to this disease, including:
- smoking;
- immunodeficiency due to stress, chronic pathologies, medication, unbalanced nutrition;
- long-term chronic inflammation of the vagina and other genital organs;
- cervical damage;
- early sexual activity, childbirth;
- hormonal imbalance caused by menopause, hormones, pregnancy.
Degrees
Pathology can affect different cell layers of squamous epithelium. Experts classify three main degrees of the disease, depending on the depth of localization of the disease: the more layers are damaged, the more severe the stage of the disease. According to the international classification, there are:
- Light (cin1). It is characterized by mild changes in the cellular structure, and only the lower third of the squamous epithelium is affected.
- Moderate (cin2). Changes occur in the cells of the lower and middle thickness of the epithelium.
- Heavy (cin3). Highly likely to lead to organ cancer. Pathological changes occur in all layers of the epithelium, spreading to muscles, blood vessels, and nerve endings.
Diagnostics
Since cases of dysplasia turning into cancer are common, early diagnosis of the disease is essential for preventing complications. All women over 21 years of age who are already sexually active should undergo a gynecological examination at least once a year and a cytological examination every 3 years. Diagnosis of pathology includes:
- examination of the uterine cervix using mirrors (the method helps to identify changes in the color of the mucous membrane, spots, epithelial growth, etc.);
- examination using a colposcope (patients are often prescribed colposcopy, which allows you to examine the genitals with optical magnification and at the same time carry out diagnostic tests by treating the cervix with a solution of acetic acid and Lugol);
- histological examination of a biopsy (a fragment of tissue from the uterine cervix, presumably taken from foci of dysplasia, is studied);
- cytological smear analysis;
- immunological CPR methods (help to identify HPV infection, determine the strain and level of viral load).
Biopsy
Cytological research involves studying the composition of cells and tissue structure. The sample taken is called a biopsy, which is taken from the cervix by making a smear from its surface. For this, special instruments are used - brushes or a spatula, which are passed along the outer part of the organ and inserted 1-2 cm into the cervical canal. The resulting sample is placed on a clean glass, allowed to dry a little and sent to the laboratory for study.
In a laboratory setting, a smear is stained with special dyes to see the changed cells and confirm the diagnosis. Indications for this diagnostic method are:
- the patient complains of irregular periods;
- prevention and early detection of dysplasia in women over 18 years of age;
- vaginal dysbiosis;
- planned installation of the spiral;
- multiple sexual contacts with different partners;
- endocrine pathology (obesity);
- infertility treatment;
- suspected presence of HPV or herpes virus;
- long-term use of oral contraceptives.
Cervical dysplasia and pregnancy
During pregnancy, the female body becomes more vulnerable than before, since at this time a state of immunosuppression develops. Due to disruption of the normal protective function of the vaginal microflora and deterioration of local barrier reactions, it becomes the cause of the development of various pathological conditions that contribute to the appearance of dysplasia.
The development of pathology during pregnancy occurs less frequently than before pregnancy. Experts identify some risk factors for cervical dysplasia, which include:
- alcohol consumption;
- disrupted diet;
- smoking;
- consumption of carcinogenic products;
- negative impact of environmental factors.
In the presence of such factors during pregnancy, a decrease in the reactivity of the whole organism occurs, which is accompanied by the development of functional and morphological changes in systems and organs. However, the vast majority of women are not inclined to this lifestyle, so they carry a child normally even with metaplasia. Possible complications of dysplasia during pregnancy are:
- threats of miscarriage;
- premature birth;
- intrauterine infection of the baby.
Treatment of cervical dysplasia
The key task of doctors when treating pathology is to avoid the occurrence of cancer. In addition, treatment is aimed at relieving symptoms and preserving the woman’s reproductive function in full. Depending on the degree of dysplasia and the condition of other organs/systems, the patient is prescribed suitable methods of therapy. These include:
- taking medications;
- carrying out physical procedures;
- surgical intervention (for severe disease).
Since dysplasia of the initial (mild) stage of development often goes away on its own after 1-2 years, provided that the body is cured of HPV, modern medicine does not recommend treatment at this stage. In this case, therapeutic tactics include:
- regular examination within 2 years from the date of diagnosis of dysplasia;
- cytological analysis, colposcopy annually;
- treatment of sexually transmitted infections;
- fight against bad habits;
- correction of disorders in the endocrine system;
- selection of alternative methods of contraception (the IUD is removed).
If the disease is mild, the doctor may prescribe removal of foci of dysplasia using local drugs for chemical coagulation (Vagotil, Solkogin). For the treatment of grade 2 or 3 disease, surgical methods are used such as:
- laser treatment;
- cauterization;
- photodynamic therapy;
- cryodestruction;
- radio wave treatment;
- photodynamic therapy;
- electrical conization.
Drug therapy
Conservative treatment involves prescribing to patients various medicines of natural and inorganic origin. These can be oils, plant extracts, antiseptics, ointments, saline solutions, etc. For mild cases of the disease, doctors often prescribe the following medications:
- antibiotics (only in the presence of infectious sexual diseases such as ureaplasmosis, chlamydia, colpitis, vaginitis, etc.);
- vaginal suppositories (relieve symptoms of the disease, normalize the vaginal microflora);
- anti-inflammatory drugs;
- immunostimulants;
- vitamin complexes.
To prevent inflammation, the development of secondary infections and other complications before or after surgery, the doctor may prescribe the following medications:
- Terzhinan. Prevents purulent-inflammatory complications, helps maintain the structure of healthy tissues and the balance of the vaginal environment. The advantage of the drug is that it quickly eliminates any signs of infections, including fungal infections. The downside of the drug is its relative high cost.
- Genferon. Eliminates papillomaviruses, herpes and other bacterial pathologies and fungi. As a rule, use 1 suppository twice a day. The disadvantage of the drug is the duration of treatment (longer than 10 days). The advantages of Genferon are a wide spectrum of action, the ability to be treated even during pregnancy or lactation.
- Isoprinosine. It is an immunostimulant and at the same time destroys viruses. As a rule, it is prescribed before and after cervical surgery. The downside of the product is that it gives the maximum effect when treating herpes, not HPV. The advantage of Isoprinosine is its high efficiency and speed of action.
Surgical treatment
The key indication for eliminating dysplasia surgically is the development of the disease to grade 2-3. Modern gynecology uses several types of operations for cervical disease. These include:
- organ amputation;
- loop electroexcision (diathermocoagulation);
- laser cauterization/conization (vaporization);
- resection using the “cold knife” technique;
- cryodestruction (coagulation with nitrous oxide).
Laser therapy
This surgical method is laser cauterization of a pathological area using low power, and is essentially evaporation, since the device almost completely destroys affected cells located at a given depth (maximum 7 mm deep into the epithelium), without affecting healthy tissue. Laser conization of the cervix requires local anesthesia, can stimulate uterine spasms and cause burns, but the method avoids bleeding due to the simultaneous coagulation of damaged vessels.
If necessary, during the procedure the doctor may take a tissue sample for histological examination. Minor bleeding may occur only when the scab is removed, a week after the operation. The advantages of laser therapy are:
- absence of scars;
- control of laser beam penetration depth;
- complete removal of pathological tissue.
Cervical amputation
Excision of the organ is considered a gentle method of surgical removal of foci of infection, therefore it is widely used in gynecology. During the procedure, the surgeon performs a high cone-shaped resection of the tissue, while preserving the organ. The operation takes place under general anesthesia. Uterine dysplasia can be treated with several types of surgery. The main methods include:
- simple extirpation (removal of the uterus along with the cervix);
- total extirpation (removal of the uterine cervix, organ body, appendages and local lymph nodes);
- extended extirpation (excision of the uterus with the cervix, ovaries);
- amputation of the uterine cervix.
The latter method is performed exclusively vaginally, laparoscopically or laparotomically. Minimal intervention involves a laparoscopic method for treating the lining of the cervix, however, it does not provide the opportunity for revision and is ineffective in the presence of malignant tumors. With the help of laparotomy, changes in surrounding tissues can be studied. The vaginal method is widely used for the treatment of dysplasia, since it is optimal for removing atypical tissues and gives excellent results.
To treat precancerous diseases, several types of organ amputation are used depending on the method of intervention. These include:
- ultrasonic;
- radio wave;
- knife (the operation is performed with a scalpel);
- laser;
- cryodestructive.
Consequences
Dysplasia is a progressive pathology that is important to begin treating as early as possible. The disease in the absence of therapy or its unsuccessful outcome threatens the following complications:
- bleeding during destruction or after it;
- the appearance of abnormal labor forces due to deformation of the uterine cavity and stenosis of the cervical canal;
- infertility caused by cervical intraepithelial neoplasia or ascending infection, for example, endometritis or chronic salpingitis;
- relapse of the disease;
- menstrual irregularities;
- transition of pathology to cancer.
Prevention
The initial examination after treatment of dysplasia is carried out 3-4 months after surgery. In this case, the doctor takes cytological smears, which are subsequently given to the patient quarterly. Negative results, indicating the absence of relapse, provide an opportunity to carry out the examination as planned (during annual clinical examinations). In order to prevent the recurrence of pathology, it is recommended:
- carry out timely sanitation of foci of infection;
- follow a balanced diet, including foods that contain all vitamins and microelements;
- regularly visit a gynecologist (1-2 times a year) and undergo a cytological examination (once every 2-3 years);
- use barrier contraception;
- give up smoking and other bad habits.
Video
Cervical dysplasia is a disease in which there are atypical cells on the mucous membrane of the cervix. Atypicality means a change in the structure of cells (thickening, proliferation, disruption of their “specialization”), as well as in the maturation and rejection of the epithelium. Cervical dysplasia is a precancerous disease, as it can potentially develop into cervical cancer.
Causes
There are three types of disease development factors:
- exogenous (acquired): infection human papillomaviruses , herpes virus; sexually transmitted diseases (ureaplasmosis, chlamydia, mycoplasmosis, trichomoniasis, gonorrhea), multiple births or abortions;
- endogenous (internal environmental factors): hormonal disorders, decreased immunity;
- mixed factors.
The main role in the development of the disease belongs to HPV. However, detection of HPV does not mean that a woman will develop cervical dysplasia or cervical cancer. The likelihood of this depends on the functioning of the immune system.
Symptoms of cervical dysplasia
There are no characteristic symptoms of the disease. Very often, cervical dysplasia in the initial stages does not cause any symptoms. In many patients, the cervix is visually unchanged. Signs of diseases of the reproductive system may appear:
- Leucorrhoea (associated with vaginitis)
- Pain (if present) inflammation of the uterine appendages)
- Bloody discharge (uterine fibroids, polyps)
Bloody discharge may appear after sexual intercourse, douching, or a gynecological examination. In severe stages of dysplasia, aching pain in the lower abdomen may bother you.
Diagnostics
A visual examination of the cervix by a gynecologist often does not show the presence of changes. Ideally, every woman should undergo a cytological examination annually (PAP test, oncocytology, cytomorphological examination of the cervical epithelium), which allows to refute or confirm the diagnosis.
For a complete diagnosis of cervical dysplasia, the following are used:
- Colposcopy - examination of the cervix with a colposcope with a magnification of 10 times or more
- Cytological examination of a smear - carried out annually for preventive purposes and allows you to detect atypical epithelial cells and HPV marker cells
- Targeted biopsy - under the control of colposcopy, a piece of tissue is excised from a suspicious area of the cervix for further histological examination. Accuracy of histological examination - 100%
- PCR method - the most reliable way to determine HPV in any body fluid.
Classification
Depending on the severity of the atypical characteristics of the cervical cells, three degrees of cervical dysplasia are distinguished:
- CIN I - mild dysplasia
- CIN II - moderate dysplasia
- CIN I I I - severe dysplasia
The degree (stage) of the disease is determined taking into account the depth of penetration of the pathological process.
Patient Actions
If HPV is detected, the patient should be under the supervision of a gynecologist and undergo smears for cytological examination every 3-4 months.
If grade 1-2 dysplasia is detected, the patient should be observed by a doctor for 6-12 months without surgery. Often, after antiviral therapy (against human papillomavirus, herpesvirus infection) and subsequent colposcopy, dysplasia disappears or becomes milder.
Treatment of cervical dysplasia
Treatment tactics depend on the woman’s age, the degree of dysplasia, the size of the pathological area, and the presence of concomitant diseases.
Patients with mild dysplasia are prescribed conservative treatment (anti-inflammatory and antiviral drugs). In case of moderate and severe dysplasia, as well as in case of ineffectiveness of treatment for mild dysplasia, destruction of the dysplasia focus is carried out. To do this, use one of the following methods or a combination of them:
- argon plasma ablation (coagulation)
- laser coagulation
- radio wave coagulation
- cryodestruction of the cervix
- diathermocoagulation
- knife amputation or conization of the cervix. Electroconization of the cervix is often performed.
With these interventions, the woman retains her reproductive function. The removed tissues are sent for histological examination. After the operation, the patients are under dynamic observation.
Complications
If left untreated for a long time, cervical dysplasia can develop into a malignant tumor.
Prevention of cervical dysplasia
Preventive measures include:
- Undergoing regular preventive gynecological examinations
- Monitoring the progression of HPV (if detected)
- Timely treatment of HPV.
Cervical dysplasia is a gynecological pathology in which a change in the condition of the epithelial layer lining it occurs on the mucous membrane. Translated, this term means the phenomenon of “disorderly growth.” At the same time, changes occur in the cell membranes in their upper layers, which can cause the cells to degenerate into malignant tumors, leading to.
Such changes in the mucous membrane of the cervix are increasingly being detected among women of childbearing and older age and can lead to disability and death of the patient.
Research in this area confirms that dysplasia occurs in approximately 40% of women. That is why specialists from all countries strongly recommend starting treatment for this pathology immediately after its detection.
The reasons for the development of atypia of the epithelial layer of the cervix are the following factors:
- infections transmitted due to early sexual activity or a large number of sexual partners (including papillomatous infection in unvaccinated women);
- hormonal imbalance caused by illness or taking hormonal medications ( hyperestrogenism);
- chemical irritation, including smegma;
- mechanical deformation of the cervix due to complicated childbirth, abortion
Hereditary predisposition and work in hazardous working conditions (oil refineries, mining operations) can contribute to the development of cervical dysplasia.
Symptoms
Dysplasia, or cervical intraneoplasia, is not manifested by any complaints. It is also not visible during a gynecological examination. Sometimes there are areas of redness on the cervix or whitish plaques, as well as signs of underlying diseases - leukoplakia, cervical ectopia. Therefore, in-depth diagnosis of the disease is very important.
Stages of the disease
Without treatment, in approximately 40% of patients, within 3 years, dysplasia from a milder stage progresses to a more severe one, and then to cervical cancer.
Diagnostics
To identify a pathology such as cervical dysplasia, a doctor may prescribe the following diagnostic tests to a woman:
- standard gynecological examination;
- cytology smear (or Pap test);
- tests for the detection of types 16, 18, 31, 33, 45, 51, 52, 56, 58 and 59 (the most oncogenically dangerous of them are viruses of types 16 and 18);
- colposcopy;
- curettage of the cervical canal;
- targeted biopsy of cervical tissue.
Detailed diagnosis of a pathology such as cervical dysplasia, in many cases, allows one to avoid the degeneration of disorders into cancerous tumors.
How can dysplasia affect subsequent pregnancies and its treatment during pregnancy?
Treatment of dysplasia during gestation may be postponed in cases where the woman’s condition is not in danger of cell malignancy. Treatment tactics are selected individually and consist of those methods of therapy that can be used during pregnancy.
In some cases, even during pregnancy, dysplasia is treated surgically if there is a risk of it degenerating into cancer.
Treatment
Treatment tactics for dysplasia are determined based on the following indicators:
- degree of dysplasia;
- general health of the woman;
- a woman's desire to give birth to a child.
The following methods can be used to treat grade I dysplasia:
- Cryodestruction. To perform this type of treatment, the doctor freezes the affected layers of the cervix. They die off and disappear on their own after final healing. After this procedure, no scars are left on the cervix, and it can be used to treat nulliparous women or those women who are planning to conceive a child.
- Laser removal. To perform this type of removal of altered tissue of the uterine mucosa, the doctor uses special equipment that “cauterizes” the layers with a laser beam. After healing, the coagulated tissues are rejected on their own, and no scars remain on the cervix.
- Removal using a radio wave knife. To perform this method of treatment, the doctor uses a radio wave knife, which eliminates the affected tissue of the mucous membrane. Subsequently, they are rejected on their own, and scars and scars do not remain on the neck.
- Cauterization with a diathermocoagulator. This technique has been used less frequently in recent years. Because it can be replaced by more modern and gentle methods for removing altered tissues of the mucous membrane.
After eliminating the affected tissues of the mucous membrane, the doctor recommends that the woman follow certain rules:
- Mode. In the first days after the operation, the patient should not sit, as this position of the body can contribute to tissue trauma. The duration of such refusal is determined by the doctor.
- Refusal of sex. The duration of such failure is determined by the rate of healing of the surface of the cervix and the technique used.
- Hygiene. Use only pads for hygienic purposes. This method of preventing leakage is explained by the fact that inserting a tampon can damage the healing mucous membrane, and tissue healing will take a longer time.
- Avoid douching. This method of cleansing the vagina, performed for hygienic purposes, has been abandoned in most civilized countries. When inserting a stream of water and a tip, a woman can injure the cervix and cause an infection.
- Refusal of heavy physical labor and sports. Additional stress created by physical stress can contribute to traumatization of unhealed tissue and impair the healing process.
- Taking medications that are prescribed by a doctor. The list of such prescriptions may include the following drugs: Nurofen, Diclofenac, Dikloberl, Genferon, etc.
- Refusal to use folk remedies to “treat” erosion. On the Internet, users often come across recommendations that treatment of cervical dysplasia can only be carried out using traditional methods. This recommendation is erroneous, because pathological changes in cells using traditional methods are impossible. Imaginary recovery in such cases can only be observed when trying to cure grade I dysplasia.
Treatment of dysplasia II, and especially III degree, often includes conization of the cervix and a thorough examination to exclude cervical cancer. If a woman is over 40 years of age, has underlying health conditions (such as large uterine fibroids) and does not want to have any more children, she may be offered removal of the uterus and cervix. In any case, the decision is made jointly by the patient and the doctor.
Cervical dysplasia is a rather serious gynecological disease that can lead to cancerous degeneration of cervical cells. That is why gynecologists recommend regular preventive examinations and visiting the doctor at the appointed time, without postponing the visit to him “for later.” Remember this and be healthy!
Which doctor should I contact?
It is necessary to be regularly observed by a gynecologist. If necessary, examination and treatment is carried out by a gynecological oncologist. A woman with dysplasia should consult an endocrinologist; if she is diagnosed with human papillomavirus, consult an infectious disease specialist; and if she has sexually transmitted diseases, consult a venereologist.
16% of all oncological diseases are caused by a malignant process in the cervix.
This process does not occur suddenly. Cervical cancer is a consequence of the gradual development of the disease, which in the vast majority of cases results from dysplasia.
What to do if dysplasia is detected? Is it curable or not? Is it possible to stop its transformation into cancer?
Dysplasia today can be treated quite effectively, so this pathology is not a death sentence, and it is quite possible to prevent its transformation into oncology.
The time during which dysplasia turns into cancer, which is not yet accompanied by germination into surrounding tissues, averages from 1 to 5 years, depending on the degree of the diagnosed pathology.
General information
- low immunity;
- endocrine diseases;
- heredity;
- the presence of condylomas on intimate organs;
- early intimacy and early childbirth;
- a large number of births, as well as difficult births;
- mechanical damage to the mucosa;
- intimate intimacy with a man who has an oncological process in the penis;
- smoking;
- avitaminosis.
Degrees of pathology
Dysplasia is divided into three stages, differing in the severity of the lesion:
- – – a third of the lower layer of the epithelium is affected, but the middle and superficial layers of the mucosa have a normal location;
- – – the lesion covers approximately 2/3 of the epithelium, and pathological changes are already beginning to occur in the layers;
- – – non-invasive cancer, which differs from the malignant process in that the stroma remains unaffected, however, most of the epithelium is affected.
If grade 3 dysplasia remains for a long time without adequate treatment, the disease transforms into invasive cancer, with all the ensuing consequences.
Treatment methods for dysplasia depend on the severity of the disease. In the initial stages, the disease can be cured using traditional medicine and conservative methods, but in advanced stages such treatment will be ineffective. In difficult situations, it is advisable to prescribe surgical treatment of the pathology. Currently, there are a large number of methods that are successfully used in practice. The safest, but extremely effective methods today are considered to be PDT and removal of affected lesions using radio waves. This is a gentle treatment that is not contraindicated for women who subsequently plan pregnancy.
Diagnosis of the disease
Must be comprehensive. First of all, the doctor examines the patient in a gynecological chair and, if pathological foci are detected in the cervical area, sends the woman for additional examination.
They include:
- cytological smear analysis;
- scraping;
- PCR analysis;
- test for sex hormones;
- clinical analysis of urine and blood;
- biopsy.
Hardware examinations are also carried out:
- Ultrasound– through the abdominal wall, but transvaginal examination is considered more accurate. Virgins may undergo transrectal examination;
- colposcopy- a study that uses optical equipment to visualize the mucous membrane of the cervix at a 30-fold size.
Drug treatment
Drug treatment considered effective in the initial stages of the disease As a rule, such treatment is prescribed for a course of three months. If positive dynamics are observed, it can be continued, otherwise surgery is prescribed.
The following drugs are prescribed:
- immunostimulants. Since the most common cause of dysplasia is the papilloma virus, it is necessary to boost immunity so that the body can independently fight the infectious agent. In most cases it is prescribed Isoprinosine, Reaferon, Prodigiosan and others. It must be said that such treatment continues even after getting rid of the pathology in order to avoid relapses;
- antibiotics. This group of drugs is prescribed only to eliminate background infectious processes, if they occur. As a rule, dysplasia often develops against the background of gonorrhea, chlamydia and other infections, which can only be defeated with the help of antibacterial agents. Most often prescribed Terzhinan, Hexicon, McMirror, Klion D, Metronizadol, Clindamycin and so on. The drug is selected individually in each case, since the type of infection must be taken into account;
- preparations for restoring microflora. Dysplasia negatively affects the condition of the mucosa, which entails an increased risk of infections and fungi. Therefore, for dysplasia it is prescribed Acylact, Lactonorm, Lactozhinal and others;
- Vitamins in the treatment of dysplasia are extremely important, especially folic acid, selenium, E, B, C and A.
The use of folk remedies
Can help cope with dysplasia only if used as a complementary therapy to conservative treatment. Before using any traditional methods, you should consult your doctor.
Here are some of the most effective recipes:
- aloe. The juice of this plant has anti-inflammatory properties and also contains many vitamins. A freshly cut aloe leaf is crushed to form a paste, then the juice is squeezed out of it, a tampon is moistened and inserted into the vagina for 5 hours. This procedure is recommended to be carried out every day for a month;
- calendula. The flowers of this medicinal plant have a bactericidal effect, so it is recommended for use in the presence of genital infections, which often accompany dysplasia. 20 grams of flowers are poured into a glass of olive oil, left for a week in a dark place, and then soaked in a tampon and inserted into the vagina for 3-5 hours;
- sea buckthorn oil. In addition to anti-inflammatory and antibacterial properties, sea buckthorn oil accelerates regeneration processes in tissues. It is recommended to insert a tampon with sea buckthorn oil into the vagina overnight;
- propolis. Beekeeping products have a very wide spectrum of effects, one of which is increasing local immunity. 10 grams of propolis are mixed with butter (200 g) and placed in a water bath. After 15 minutes, the composition is cooled and filtered through cheesecloth. A tampon is moistened with the resulting composition and inserted into the vagina overnight. This recipe is contraindicated for women who are allergic to bee products;
- eucalyptus. In addition to antiseptic properties, this plant has an analgesic effect. Pour a couple of tablespoons of leaves into a glass of water, boil for 5 minutes, and leave to infuse. Then use it as a douche - a tablespoon of the product is diluted with a glass of warm boiled water.
Surgical intervention
In the case of a severe form of the disease, and also if conservative medicine does not bring a positive effect, the pathology is treated surgically.
The following methods are used for this:
- chemical coagulation– affected areas of the mucous membrane are treated with special preparations that provoke burns and tissue necrosis;
- diathermocoagulation– excision of affected tissue with electric current. The operation is quite painful, so it is performed under local anesthesia;
- cryodestruction– the mucous membrane is exposed to liquid nitrogen, which leads to freezing and detachment of pathological tissues;
- laser vaporization– cauterization of dysplasia with a laser;
- – carried out using a special Surgitron device;
Full or partial surgery carried out in the following cases:
- spread of the pathological process along the cervical canal;
- moderate to severe disease, which is accompanied by non-invasive cancer or the presence of a large number of atypical cells;
- cervical deformity;
- frequent relapses of the disease, despite the use of various treatment tactics.
Consequences of dysplasia
The consequences of untreated dysplasia may be as follows:
- transformation into cancer. Without treatment it is observed in half of the cases;
- the appearance of scars that reduce tissue elasticity. It must be said that this complication mainly occurs after surgical treatment, but in some cases it can also occur after conservative therapy;
- decreased tissue immunity;
- the addition of inflammatory and infectious processes;
- relapses.
HPV vaccine
Due to the fact that dysplasia is a consequence of the effect of the papilloma virus on the cervical mucosa, it is advisable to be vaccinated against this virus.
Currently, this vaccine is represented by two drugs:
- Gardasil– resists the penetration of strain 11 into the body, as well as the main oncogenic strains – 16 and 18;
- Cervarix– counteracts the 16th and 18th strains of the virus.
The optimal age for vaccination is 12-15 and 20-23 years. It is very important to undergo a full gynecological examination before vaccination, especially if the girl has already had sexual intercourse.
NOTE!
If the papilloma virus is present in the body, vaccination becomes meaningless.
Cervical dysplasia is considered not just a pathology of the reproductive system, but a precancerous condition. Its danger lies in the fact that under the often unexpressed symptoms lies a potential danger and a high risk of formation.
Dysplasia is structural pathological changes in the mucous membrane of the cervix at the cellular level. Most often this diagnosis is confirmed in women who are of childbearing age. The earlier dysplasia is detected, the lower the risk of the process becoming cancerous. The prognosis in this case always depends on the degree of cervical dysplasia.
note: degeneration of ordinary cellsepitheliumthe cervix becomes pathological gradually:hyperplasia, proliferation, disruption of cell differentiation and the processes of their physiological maturation and aging.
Causes of cervical dysplasia
Experts are 98% sure that the cause of this pathology is a long stay (oncogenic type 16 and 18) in the cervical mucosa. 12-18 months are enough for the virus to provoke dysplasia. Among the factors that increase the risk of its formation are the following:
- frequent abortions;
- hormonal imbalance in the body (hormonal contraceptives, premenopause);
- Chronic genital infections;
- early onset of sexual activity;
- smoking;
- poor nutrition;
- genetic predisposition;
- mechanical injury to the mucous membrane of the neck;
- promiscuity;
- high parity (many births in history);
- cancer of the head of the penis in a partner;
- background pathological processes on the cervix (ectopia, ectropion);
- early childbirth;
- a decrease in the body’s immune forces against the background of systemic pathologies, taking certain medications.
Cervical dysplasia: degrees
In official medicine, cervical dysplasia is usually called cervical intraepithelial neoplasia (CIN - the Latin abbreviation of the name). It is classified based on the presence of atypical cells in a smear, which is taken by a gynecologist from the surface of the cervical epithelium.
The degree of dysplasia is determined based on characteristics such as:
- the depth of penetration of cellular modifications into the epithelial layers;
- structure of altered tissues;
- morphology of the pathological area.
Healthy mucosa has 4 layers, which are affected depending on the degree of dysplasia.
Important: Statistics say that 25% of women have cervical pathology, while in 40% of cases it is detected in pregnant women and in 20% in non-pregnant women.
Cervical dysplasia grade 1 (weak)
It determines the following changes:
- unpronounced modification of the basal layer;
- symptoms of presence - dyskeratosis and koilocytosis in tests;
- changes penetrate to a depth of at least 1/3 of the epithelium.
Cervical dysplasia grade 2 (average)
It diagnoses deeper changes in tissue structure:
- pronounced structural lesions;
- the pathological process affects ½ of the epithelium;
- morphological changes at the cell level progress.
Cervical dysplasia grade 3 (severe)
With this degree of dysplasia, the process extends as deeply as possible:
- with it, atypical lesions are noted on 2/3 of the mucous membrane of the cervix;
- structural changes are strongly expressed;
- there is pathological mitosis of cells;
- large hyperchromic nuclei are found in the cells;
- pathological cells exist exclusively in the mucosa and do not spread to blood vessels, muscles and neighboring tissues.
Cervical dysplasia: symptoms
The typical clinical picture in most cases is already severe cervical dysplasia and the addition of a secondary infection (colpitis). A woman may not even be aware of this disease; sometimes changes in the cervix are not visible to the gynecologist during examination, or they are more insignificant. This is why it is important to undergo routine examinations every six months, because the most informative method of diagnosis is cervical smears, which are taken during each visit to the doctor. A patient with cervical dysplasia may present the following complaints:
- leucorrhoea, or discharge (abundant with an unpleasant odor);
- vaginitis;
- pain due to adnexitis;
- spotting (often contact, that is, after sexual intercourse, gynecological examination);
- burning sensation;
- pain that occurs during sex.
Important: the presence of similar symptoms in cervical dysplasia is an urgent reason to seek medical help. Without appropriate therapy, the disease will progress and may develop intosquamous cell carcinoma.
Diagnostics
It would not be amiss to repeat that the most important rule that a woman should adhere to is a scheduled visit to the gynecologist every 6 months and an unscheduled visit for any alarming or disturbing symptoms. This allows pathological changes to be identified in time and treatment to begin on time. The diagnostic plan for suspected cervical dysplasia includes:
- Gynecological examination. It is performed using gynecological speculum. During the procedure, the doctor detects a visually noticeable change in the color of the mucous membrane, shine around the pharynx of the cervix, atypical growth of the epithelial layer, spots.
- Instrumental studies.
- Laboratory research:
Treatment of cervical dysplasia
Treatment for cervical dysplasia and treatment methods depend on certain factors:
- woman's age;
- degree of dysplasia;
- size of the pathological area;
- concomitant diseases;
- desire to have children in the future.
Treatment of cervical dysplasia of the 3rd degree, the most severe, should be carried out by a gynecologist-oncologist, using exclusively surgical techniques. Stages 1 and 2 of dysplasia are treated by a local gynecologist. A woman with confirmed cervical dysplasia must be registered with a dispensary. If the patient is young and has grades I and II dysplasia and a small affected area, it is possible to use a wait-and-see approach. At this time, the doctor monitors the woman’s condition and the condition of dysplasia, which can progress or regress.
There are certain cases when treatment for cervical dysplasia is not advisable.:
- young age of the woman (less than 20 years);
- absence of human papillomavirus infection in the body;
- dysplasia without spreading to the cervical canal;
- lesion of cervical epithelium by point type dysplasia.
Today the following methods of therapy are used::
- operational;
- medicinal.
Drug therapy
It includes drugs for enhancement in the form of immunomodulators, as well as interferon agents. They are used for extensive lesions and recurrent forms of dysplasia.
note: If the papilloma virus is detected in the body, a woman must be prescribedantiviral therapy. Very often, after such treatment, dysplasia disappears on its own or regresses to a milder stage.
Surgical treatment of cervical dysplasia
It is resorted to in the case of a double positive test result for dysplasia. Before any surgical procedure, anti-inflammatory drugs are prescribed to sanitize the lesion. Very often, after preoperative treatment, the degree of dysplasia damage decreases in size or completely disappears. Operations are always performed in the first phase of the monthly cycle, namely on days 6-10, provided there is no inflammatory process in the vagina and uterus, as well as pregnancy.
Modern surgical techniques for treating cervical dysplasia are as follows::
- Laser surgery(laser vaporization, laser conization, laser cauterization). This is a method of influencing pathological tissues using a low-intensity laser beam. Due to this, areas of dysplasia are heated and destroyed, and necrosis forms in their place.
- Cold destruction(cryodestruction, cryoconization).
- Electric excision(diathermocoagulation, loop electrical excision procedure).
- Conization of the cervix. In this case, a cone-shaped section of the neck is removed using a special knife in the form of a loop.
- Cryotherapy. This technology involves eliminating the lesion on the cervix with liquid nitrogen.
- Radio wave surgery.
- Cervical amputation. Radical removal of the neck when other methods are impossible or ineffective.
After surgical therapy, a woman should adhere to some medical recommendations:
- refusal of sexual activity for 1-1.5 months;
- do not lift heavy objects;
- do not douche;
- do not use tampons;
- do not go to the sauna or bathhouse.
After 3 months, the woman must undergo a repeat colposcopy and take a smear from the cervix for cytology. If everything is normal, she is removed from the medical examination. Rarely, after surgery to remove dysplasia, the following complications can develop:
- relapse;
- transition to the stage of exacerbation of chronic inflammation in the pelvis;
- scars on the neck;
- dysmenorrhea (menstrual dysfunction).
Prevention of cervical dysplasia
To prevent the development of this pathology, you should follow certain recommendations:
- mandatory use of barrier contraceptives in case of casual sex;
- smoking cessation;
- timely detection and treatment of inflammatory and infectious diseases of the reproductive system;
- enriching the diet with foods high in microelements and vitamins;
- regular visits to the gynecologist.
The most progressive methods of treating cervical dysplasia are described in detail in this video review:
Yulia Viktorova, obstetrician-gynecologist
