Cervical Dysplasia - This is a form of uterine precancer, which is currently found especially often. Dysplasia means the presence of changes in the mucous membrane of the cervix, as well as the vagina, having a diverse origin.
With the development of dysplasia, disorders in the structure of the cells of the surface layer of the cervix appear. Depending on the stage of dysplasia, changes occur not only in the surface layers, but also in the deeper ones. Dysplasia is sometimes referred to as cervical erosionHowever, most experts are inclined to the idea that this term cannot fully reveal the essence of the ongoing process. Indeed, with erosion, tissue damage occurs, which is mechanical in nature, and cervical dysplasia implies the presence of damage to the structure of tissue cells. That is, with dysplasia, not only cells with signs of atypia develop, but also a pathological change in the tissue complex as a whole occurs.
Types of cervical dysplasia
When establishing a diagnosis, specialists use the classification of dysplasia, which determines the degree of damage to the stratified squamous epithelium of the cervix.
If the patient is determined cervical dysplasia of the 1st degree, then in this case a third of the thickness of the epithelium is affected. Therefore, this degree is considered easy. This stage of dysplasia is sometimes combined with edema and vacuolization of the cells of the intermediate layer.
If the patient is affected from 1/3 to 2/3 of the thickness of the epithelium, then in this case it is diagnosed cervical dysplasia of the 2nd degree. It is a medium degree of damage. In this case, the polarity of the location of the epithelium is violated.
If the patient revealed damage to the entire thickness of the epithelium, then it is determined cervical dysplasia 3 degrees, which is a severe degree of the disease. In this case, there is no division of the squamous multilayer epithelium into layers, there is a pronounced cellular and nuclear atypism.
Causes of cervical dysplasia
In approximately 95% of cases, dysplasia develops at the site of cervical transformation. It is in this zone that the transition of the cylindrical epithelium into a flat one is noted. Under the influence of a mechanical or physical nature, dysplasia develops in this place.
There are several factors that determine the development of this disease in women. In particular, cervical dysplasia develops against vaginitis, vaginosis, colpita. In addition, the cause of dysplasia often becomes ectopia and cervical erosion, vulvar leukoplakia. The disease is also often diagnosed as a consequence. immunodeficiency in patients Aids, sexually transmitted diseases.
Very often, dysplasia of the epithelium occurs against the background of damage to the epithelium of the mucosa human papillomavirus. Under the influence of the virus, the proliferation of cells of the basal and parabasal layer occurs. The cells affected by the virus gradually grow and move to the upper layers of the epithelium, in which the virus multiplies. As a result, a viral attack provokes the occurrence of dysplasia.
Specialists also identify other factors affecting the development of dysplasia: the early onset of sexual life, as well as early childbirth (under the age of 16 years); frequent sexual intercourse with intermittent partners; neglect of contraceptive methods, in particular, the use of a condom; numerous abortions or childbirth. There is a higher risk of dysplasia in women who smoke, since hypoxia manifests itself under the influence of tobacco smoke. As a result, the local immunity significantly worsens, and the risk of microtrauma of the epithelium increases significantly. A long period of use of combined oral contraceptives can also provoke cervical dysplasia.
Also, as a factor affecting the onset and development of the disease, it should be noted the deficit of some vitamins (A, C, β-carotene), poor quality of life, the presence of a certain genetic predisposition to the disease.
The manifestation of hormonal dysfunctions of any etiology can be another reason for the development of this ailment.
Symptoms of cervical dysplasia
As a rule, there are no pronounced clinical signs with the development of cervical dysplasia. However, with a severe, advanced degree of dysplasia, a woman may experience periodic pain in the lower abdomen. In addition, bloody discharge in small quantities can sometimes appear.
About 10% of women have a latent course of the disease. But most often microbial infections join dysplasia. In this case, the patient already notes signs characteristic of other diseases: noticeable changes in the consistency and nature of the discharge, pain, burning, itching.
Diagnosis of cervical dysplasia
Due to the lack of pronounced symptoms in the diagnosis of cervical dysplasia, the use of clinical, instrumental and laboratory research methods that allow us to evaluate the cellular structure of the cervical epithelium is of particular importance. The feasibility of using a specific method in each individual case is determined by the attending physician.
In the process of examination, the following methods are used: biopsy cervix uteri, simple and advanced colposcopy, endocervical curettage (the procedure consists in curettage of the cervical mucosa).
In addition, samples with acetic acid, studies for the presence of genital infections, determination of the immune status are used.
If during colposcopy, areas of the epithelium are found on which dysplasia is likely to develop, then a biopsy and subsequent histological examination are performed. This method allows you to accurately determine the severity of the disease.
Treatment of cervical dysplasia
Sometimes treatment for cervical dysplasia is not practiced at all. The need for specific treatment methods is determined by the attending specialist, while being guided by a number of factors. In nulliparous women of a young age, sometimes the disease goes away on its own, provided that we are talking about mild or moderate dysplasia. In this case, the following conditions must be met: the patient's age does not exceed 20 years, there are only point lesions, the pathological process did not affect the cervical canal, there are no viral infections in the body. But even in the absence of treatment, in this case, constant monitoring by a doctor and conducting studies every few months is indicated.
When prescribing treatment for dysplasia, it is necessary to use two directions: removal of the site affected by the disease, and subsequent rehabilitation treatment. It is important to take into account the degree of the disease, the woman's age, the presence of childbirth in the anamnesis, and other risk factors.
In order to choose the correct method for removing the atypical site, the doctor must take into account all the individual characteristics of the patient’s health status. The fact is that certain types of surgical intervention can provoke the development of serious complications in the future. It could be the appearance of scars on the cervix, infertility, monthly cycle disorders, pregnancy disorders.
The method of chemical coagulation is most often used if a woman is diagnosed with true erosion, while the lesions are relatively shallow and not extensive. Electricity methods are also used for the cauterization procedure. This procedure is performed quickly, but after it, scars may remain on the uterus.
Often used in the treatment of dysplasia are also methods of cryodestruction and cryoconization, consisting in freezing the affected areas by applying liquid nitrogen. However, in the case of severe dysplasia and the manifestation of a malignant process, freezing is not used. The disadvantages of this technique is the inability to precisely control the depth of freezing, as well as too long the manifestation of secretions after the procedure.
Cauterization of tissues is also performed using a laser. Laser operations allow you to most accurately affect areas that have been affected. But at the same time, such an intervention is quite painful, in addition, several days later, the occurrence of bleeding.
Excision by cold-knife conization is currently used infrequently, since this method is fraught with the appearance of a number of complications: high trauma, severe bleeding. Subject to diagnosis first stage cancer a woman is prescribed amputation of the cervix.
It is important to consider some features of the treatment of dysplasia. It is advisable to perform the operation at the beginning of the menstrual cycle, since it is at this time that tissue repair is most active. Mostly, local anesthesia is used during the operation. General anesthesia applies only in individual cases.
In the postoperative period, women notice the appearance of secretions for about a month. In the first weeks, pain also occurs in the lower abdomen. During the recovery period after surgery, a woman is prohibited from lifting heavy loads, using tampons, douching, or having sex. Sedative medications at this time can also be used, but they are prescribed individually.
About three months after surgery, it is important to pass a cytological smear in order to verify the effectiveness of the procedure. As a rule, restoration of the epithelium occurs after 6-10 weeks. During the first year after surgery, the status of the epithelium should be checked at least once every three to four months.
As a rehabilitation treatment, it is important to take a course of taking drugs containing vitamins A, E, C, AT 6, AT 12, bioflavonoids, β-carotene, folic acid and other trace elements. In the process of research, a direct relationship was noted between the lack of certain vitamins in the body of a woman and the manifestation of cervical dysplasia. Complex multivitamin agents are also used to prevent the manifestation of dysplasia. During the recovery period, the patient’s nutrition should also include those foods that contain the maximum of these vitamins and elements. It is also recommended to use green tea every day, which positively affects the restoration of the epithelium.
When prescribing treatment methods, the doctor must take into account the nature of the diseases associated with dysplasia. Before treatment with surgery, there is a mandatory reorganization in order to eliminate inflammation, if any.
Some alternative methods used to treat cervical dysplasia are also recommended. An effective course of treatment using tampons with propolis and butter. To prepare them, melt 200 g of butter and add 10 g of pre-ground propolis. Boil this mixture for 15 minutes over low heat. After that, the liquid is filtered through several layers of gauze. The swab is soaked with this mixture and inserted into the vagina for about half an hour. The ointment should be stored in a cold place, and procedures with tampons are carried out for a month.
Also, for the treatment of dysplasia, you can prepare tampons with aloe and honey. To do this, equal parts of fresh aloe juice and honey are mixed, a swab is impregnated with the mixture, which is inserted into the vagina at night. The course of treatment is two weeks.
For daily douching, which should be carried out in the morning and in the evening, use an infusion of green tea and calendula. To cook it, you need to take one tablespoon of calendula flowers and dry green tea, pour the mixture with boiling water and leave for several hours. Douching is carried out for one month.
It’s very important to always remember that cervical disease, treatment of which is not carried out on time, can eventually become malignant. Therefore, it is necessary to undergo preventive examinations in time and take all measures to cure the ailment.
To date, the application of the correct approach to the treatment of the disease provides a cure for dysplasia and the prevention of its degeneration into a malignant form.
The doctorsSpecialization: Gynecologist / Oncogynecologist
Korchagina Elena Vyacheslavovna2 reviews1300 rub.
Vasilieva Larisa Gerasimovna1 review1 000 rub.
Dudkin Stanislav Viktorovich1 review 1200 rubles more doctors
Prevention of cervical dysplasia
Cervical dysplasia can occur not only in those women who belong to the risk groups described above. Women who have already begun sexual activity should clearly observe the terms of preventive examinations by a gynecologist.
An obligatory preventive measure for every woman should be the right approach to organizing daily nutrition: in particular, you should constantly eat dishes enriched with useful trace elements.
An important preventive measure is the complete rejection of smoking, the connection of which with the development of dysplasia has been clearly proved by scientists. It is important to observe the rules of sexual hygiene, use barrier contraceptivesto ensure timely treatment of all diseases of the genitourinary system.
List of sources
- Kondrikov, N.I. Pathology of the uterus: illustr. hand-in. / N.I. Kondrikov. - M .: Pract. honey., 2008;
- Prilepskaya V.N. Pathology of the cervix and genital infections. M .: MED press-inform, 2008;
- Neyshtad E.L., Krulevsky V.A. Differential diagnosis of cervical tumors. - SPb .: KultInformPress, 2012;
- Rogovskaya, S.I. Papillomavirus infection in women and pathology of the cervix / S.I. Rogovskaya. - M .: GO-ETAR-Media, 2005.