cervical leukoplakia - this lesion of the mucous membrane, while in the process involves the topsheet and underlying layers of epithelium.
That is, the upper layer of epithelial hypertrophy (thickening), which corresponds to the process of keratinization. Clinically areas of leukoplakia appear as whitish or whitish plaque. The disease does not occur very rarely, and is diagnosed in about every 20th woman.
Kinds
Allocate 3 forms of cervical leukoplakia:
- flat leukoplakia - affected areas are flush with normal stratified squamous epithelium (diagnosed accidentally during routine inspection);
- warty - white deposits rise above the level of the cervix can be layered on top of each other, which changes the surface of the cervix, it becomes lumpy;
- erosive leukoplakia - in whitish portions are in the form of erosion damage and / or cracks.
Depending on the results of histology (presence or absence of abnormal cells) distinguished leukoplakia, which refers to background cervical processes (flat leukoplakia) and leukoplakia related to precancerous processes (available atypical cells).
Causes of
Starting torque of the disease so far is not enough clear. It is known that all the causes of cervical leukoplakia can be divided into 2 groups: endogenous (existing within the body) and exogenous (external influence) factors.
Endogenous factors include:
- hormonal imbalance at all levels of the hypothalamic-pituitary-ovarian system (anovulation, excess or deficiency of hormones, endometrial hyperplasia, etc.);
- chronic inflammatory diseases of the uterus and appendages;
- metabolic disease;
- weakening the body's defenses.
Exogenous factors include;
- cervical injury (in labor, abortion, Rough sexual intercourse);
- early sexual activity, frequent change of sexual partners;
- urogenital infections (human papilloma virus, genital herpes, ureaplasmosis, chlamydia and others);
- cervical disease (erosion, cervicitis and others).
Symptoms of cervical leukoplakia
Typically, cervical leukoplakia occurs, hidden, that is asymptomatic and is a random finding during a routine inspection.
Some of the patients can mark such disease manifestations, like dyspareunia (pain during intercourse) and increased vaginal discharge with a bad odor. Color vaginal leucorrhoea may be different. These symptoms are usually associated with underlying gynecological diseases.
In the case of leukoplakia foci propagation beyond the cervix (vaginal wall) may cause itching and burning.
In some cases, a woman can celebrate the appearance of small bleeding from the vagina after intercourse.
When viewed in the mirrors on the cervix are detected rough or gentle raids white or grayish-white color, which are crisp, jagged or blurred boundaries. Plaque is not removed gauze.
Diagnostics
Differential diagnosis of cervical leukoplakia is carried out colpitis, Cervical erosion, warts, Cancer. Flat leukoplakia must be differentiated with lumps of mucus, fungal coating (thrush) Metaplasia.
In addition to the mandatory inspection of the cervix in the mirrors, in which are found the white raids, conducted additional research:
- 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.
- colposcopy: Colposcopy to determine the boundaries and size of lesions and suspected areas of atypia. During the sample Schiller raids are not colored in brown (iodine-negative sites).
- 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.
- 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.
- Hormonal status: according to indications determine the level of hormones in the body.
leukoplakia treatment
Treatment of cervical leukoplakia is carried out after a mandatory biopsy.
In the case of a simple leukoplakia treatment takes a gynecologist, if found signs of atypia, disease therapy determines and conducts the gynecologist-oncologist.
The goal of treatment - removal of diseased cervical lesions.
diathermocoagulation
Moxibustion leukoplakia foci of electrical shock is quite an effective method of treatment, but in recent years has lost its popularity because of the large number of post-operative complications.
cryolysis
Freezing with liquid nitrogen damaged areas. Effective and quite safe method, but has a drawback: the impossibility of processing the deep layers of cervical epithelium (relapse).
Laser therapy
Processing areas of leukoplakia with a laser beam (abnormal cells evaporate and disappear). Painless, and reliable method allowed its use in nulliparous women.
Chemical coagulation
Processing chemicals pathological sites that contain acid. Painless and effective way.
radiowave surgery
In the apparatus "Surgitron" has an electrode which is supplied to the hearth leukoplakia, but does not touch it. Due to the electrode portion leukoplakia receives radio waves destroy abnormal cells.
All of these treatments are carried out on an outpatient basis, at 5-7 days of the menstrual cycle. The healing process lasts from 2 weeks to 2 months. In the postoperative period is recommended to limit lifting weights, taking baths, sun exposure is prohibited.
When rough deformation of the cervix and severity cornification processes with atypia, produced more radical surgery (e.g., cervical amputation).
Leukoplakia in pregnancy
Upon detection of the disease is necessary to do his treatment at the stage of planning of pregnancy.
cervical leukoplakia not affect the course of pregnancy and fetal development. However, pregnancy causes a surge of sex hormones that may affect the course of the disease (progression). Therefore, pregnant women with a diagnosis of "cervical leukoplakia" to be more closely monitored.
leukoplakia treatment is delayed to the postnatal period, and deliveries are carried out vaginally. If the disease progresses and spreads to the tissues of the vagina and vulva, preference is given to operative delivery (cesarean section).
Complications and prognosis
In 15% of cases of cervical leukoplakia can turn into malignancy.
Forecast at a flat leukoplakia without atypia and cervical strain is favorable for life, and for pregnancy.
