Occurrence of the disease, statistically different clinicians is different and varies in the range of 1.1% to 12.5% of cases. The complexity of the treatment of leukoplakia follows, respectively, from the obscurity of the pathogenesis and causes of disease.
What it is?
cervical leukoplakia - a pathological change in the structure of the epithelium covering the cervix of the uterus.
Initially, the term "leukoplakia" is derived from the Greek words "white plaque" and very accurately transferred visual characteristic of the disease - the appearance on the surface of the cervical epithelium white, dense in appearance delimited spots.
Leukoplakia is cancer or not?
According to various observations transformation of leukoplakia in cancer occurs in 3-20% of cases. However, isolated cases of simple leukoplakia, which are not accompanied by atypia cells and precancerous conditions, and relate to the background processes of the body.
Classification
Depending on the macroscopic picture of leukoplakia are the following forms:
- Or verrucous warty (second stage of the disease) - whitish nodules are laminated on each other, because of which the neck It looks bumpy, and themselves leukoplakia lesions significantly rise above the mucosa and does not notice them almost it is impossible;
- Simple, which is considered the initial stage of the process, wherein the white plaques are flush with the mucosa and do not protrude above the surface, they can be easily miss during the inspection of the cervix;
- Erosive - whitish plaques on the cracked and / or erosive areas.
After the histology slices isolated plaques simple leukoplakia and leukoplakia with atypia (proliferative). Simple leukoplakia (not revealed atypical, that is prone to degeneration of cells) ranked as background processes neck. Leukoplakia with atypia (atypical cells are) considered to be precancerous.
The causes of leukoplakia
There is no single proven cause of cervical leukoplakia. It involves two groups of factors that contribute to the development of this pathology:
1) Interior:
- Related somatic diseases (diabetes, etc.);
- Genetic predisposition;
- Immunosuppression and others;
- Or allergic contact dermatitis, e.g., when installing the IUD.
2) External:
- Infection (papillomavirus, chlamydia, mycoplasma etc.);
- Inflammatory processes (endometritis et al.);
- Traumatic mucosal injury (diagnostic curettage, hard coitus et al.).
Thus, only a combination of certain factors can lead to the development of this pathology, and some women leukoplakia occurs for no apparent reason, and found quite by accident.
During pregnancy
If leukoplakia detected during pregnancy, it usually does not affect the fetus and does not cause fetal abnormalities. In this case, there is some risk to the pregnancy itself - the chances of worsening disease, which may result in occurrence of a much more serious diseases and even malignancy defeat.
Provoke such complications can be hormonal imbalance, weakened immunity or childbirth, in which the cervical tissue can be seriously damaged in tension. If the presence of a pathological process detected before pregnancy during its planning, it is necessary to get rid of it before conception. If you intend to IVF, the leukoplakia necessarily eliminate.
If treatment is not taken, complications and consequences can lead to irreversible damage such as malignancy of the pathological process.
The symptoms of leukoplakia, photos
Symptomatology leukoplakia depends on its type.
Flat leukoplakia (simple) occurs without any symptoms. Discomfort, burning feeling inside can cause warty leukoplakia.
Erosive leukoplakia can stain ichor on panty liners, especially after sexual intercourse. If leukoplakia spread to the vulva, the itching can be observed here and as a result - the appearance of tiny cracks, abrasions, scratching. These symptoms are quite vague - they are in other diseases of female genitalia.
Normally used for differential diagnosis of colposcopy and biopsy - then with high probability we can speak of leukoplakia. Most doctors are inclined except leukoplakia malignant disease, but such approval may be given only after the biopsies. In the presence of basal cells such atypical leukoplakia can not be considered benign and further treatment will already be built in view of this point.
Diagnostics
In addition to the mandatory inspection of the cervix in the mirrors, in which are found the white raids, conducted additional research:
- Colposcopy: allows you to define the boundaries and size of lesions and suspected areas of atypia. During the sample Schiller raids are not colored in brown (iodine-negative sites).
- Tests for urogenital infections: in addition to smear on the vaginal microflora is necessary to bacteriological examination for urogenital infections, primarily for the virus human papillomavirus.
- Cytology: scraping should be taken with a whitish coating. But cytology does not always show the correct result as abnormal cells deeper layers of cervical epithelium can not get into a scraping.
- Hormonal status: according to indications determine the level of hormones in the body.
- Biopsy: A biopsy is carried out aiming at the control of a colposcope, which is in 100% of cases to determine the presence / absence of precancerous process.
Differential diagnosis of cervical leukoplakia is carried out with obesity, cervical erosion, warts, cancer. Flat leukoplakia must be differentiated with lumps of mucus, fungal coating (thrush), metaplasia.
complications
The main danger of this disease is its ability to be reborn in cervical cancer. In medical terminology, this condition is called "facultative precancer," ie, state that can most likely go into cancer.
In this connection, the problem is under strict medical supervision, and experts recommend removing the changed mucous lesions.
Treatment of cervical leukoplakia
To eliminate cervical leukoplakia apply different treatments. But it is first necessary to eliminate the inflammatory process (if any) and other precipitating factors. Upon detection of an inflammation of genitals or genital infections identifying prescribers with antiviral, antibacterial, or antifungal activity protivotrihomonadnyh (depending on specific pathogen). In the case of diagnosis of hormonal disorders appointed Corrective hormone therapy.
How to treat cervical leukoplakia is caused by many factors, and the specific method of treatment is chosen in view of its advantages and disadvantages:
- The laser exposure. Laser removal of cervical leukoplakia - the most modern method of treatment. Used high-intensity carbon dioxide laser. The procedure is performed without contact and painless. This eliminates the possibility of contamination of the patient with any communicable disease or bleeding. The laser vaporizes the damaged tissue, forming a thin film which prevents blood from entering the wound and infection. Laser photocoagulation is performed on an outpatient basis, in the first week of the cycle. Immediately prior to exposure to the neck stained with Lugol's solution to determine the boundaries of leukoplakia. If you struck by not only the neck but also the walls of the vagina, in the first stage is carried out laser coagulation of lesions on the cervix, and a month later - on the walls of the vagina. Complete healing occurs after about 1.5 months after the procedure.
- Cryodestruction (freezing). Necrosis of the pathological focus on the cervix caused by exposure to low temperatures painless. As the "freezing" of liquid component is used nitrous oxide. epithelialization process is not accompanied by the formation of the scar, which is a significant advantage: the cervix retains elastic properties and will not tear in the scar area for future delivery. However, along with a high (54 - 96%) efficiency method has a significant drawback: relapses leukoplakia, especially in patients with menstrual dysfunction.
- Radiowave treatment of cervical leukoplakia. A relatively new method of treatment is not yet received widespread. A feature of the preparation of patients is mandatory prior histological examination (biopsy) Cervical modified tissues. The method uses radio waves to raise the temperature properties of the intracellular liquids, i.e. degrade leukoplakia using the "boiling" section leukoplakia.
- Moxibustion or electrocautery. Doctors often use this technique just because it is available and relatively inexpensive. But it is worth noting that moxibustion has several significant drawbacks. This procedure is quite painful and traumatic for the woman and with the pathological features of affected and healthy tissue. The consequences of its conduct can be quite unpleasant. The healing process is very long runs. After the cauterization there is no guarantee that will not have a relapse of disease.
In the event that leukoplakia is accompanied by severe deformation and hypertrophy, have resorted to radical treatment - remove the cervix. If along with leukoplakia observed inflammatory processes in the genital tract, you must first treat them. In this case, resorting to conservative treatment. Assign:
- anti-inflammatory drugs;
- broad-spectrum antibiotics;
- preparations for correction related pathologies;
- immunostimulants;
- vitamin and mineral supplements.
Treatment of folk remedies in the case of development of the state spending is not advisable, as they are ineffective. Also, do not self-medicate, as there is a danger that without adequate therapy disease can develop into cancer. Folk remedies can only be used in conjunction with traditional methods of treatment. The main therapy, they should not be. Treatment of folk remedies can be carried out only with the permission of the attending physician.
The postoperative period
Postoperatively, doctors recommend to completely eliminate sex for 1.5 months. Also, you should avoid heavy lifting, going to the sauna and bath, taking a hot bath. In addition, it is forbidden to use tampons and douching conduct. You also need to perfectly follow the rules of personal hygiene.
During the first ten days after cervical treatment (no matter what method) can appear heavy liquid separation, which should not scare. Just as the body responds to the treatment, and it is a testament to the successful healing of the wound surface.
Reviews of treatment
Some reviews of women who took the treatment of this disease:
- Ekaterina, 38 years old. I treat cervical leukoplakia traditional cauterization. there were no complications. After treatment, one and a half years successfully gave birth to a son. Therefore, we can safely say that the treatment went well.
- Eugene, 27 years old. When revealed cervical leukoplakia, the doctor offered a choice - to cauterize or remove the laser. On the recommendation of a friend stopped at the gynecologist lezeroterapii what did not regret. The procedure was uneventful, quick and painless. I recommend.
prevention
cervical leukoplakia refers to dangerous pathologies. Any form of disease, in particular, simple leukoplakia, be treated promptly.
Among leukoplakia prevention measures can be identified:
- prevention of sexually transmitted infections;
- applying a barrier method of contraception;
- correction hormonal disorders;
- regular examination by a gynecologist;
- exclusion of surgical abortion, cervical trauma at birth and curettage;
- treatment ectopia, inflammatory and infectious diseases affecting reproductive system;
After treatment, simple leukoplakia woman twice a year passes inspection, which involves colposcopy, smear on onkotsitologiyu and HPV. If after two years of relapses did not occur, the patient is removed from the account of the dispensary.
Forecast
Full treatment of this pathology is observed in almost 99% of cases. Prognosis generally favorable, provided that conducted the timely elimination of precipitating factors and begun adequate therapy. Otherwise, the process may recur. There is also a 15% probability of regeneration leukoplakia in cervical dysplasia and further in the malignant process.
