cervical dysplasia refers to precancerous diseases and represents a change in the structure of mucous membrane cells cervix, which are expressed in the thickening, sprawl, violation "specialization" of the cells, as well as the maturation and rejection epithelium.
Unlike cervical erosionDysplasia involves not only the superficial layers of the epithelium, but also profound.
Most often, cervical dysplasia affects women of childbearing age, 25 to 35 years.
grade dysplasia
Depending on the level of mucosal lesions, cervical dysplasia has three degrees:
- first (light) degree - in the third process involved epithelial thickness;
- second (average) degree - struck to 2/3 epithelial thickness;
- third (heavy) - pathologically altered entire layer, and the intermediate cell layers deep are atypical structure.
Causes
The main cause of cervical dysplasia is a long existence in the mucosa of the human papillomavirus (HPV onkotipy-16 and HPV-18).
Without timely and adequate treatment after 1-1.5 years of existence in the epithelium of the cervical mucous virus causes changes in its cells, thereby developing dysplasia.
In addition, an important role in the development of the disease are predisposing factors:
- early sexual life (16 years);
- promiscuity;
- parity (multiple births);
- abortion and scraping the uterine cavity;
- smoking (increases the risk of disease in 4 times);
- infection, sexually transmitted diseases (gonorrhea, chlamydia and others);
- cancer of the head of the penis with a partner;
- deficiency of vitamins A, C and trace element in the diet;
- genetics (genetic predisposition to cancer);
- adverse social conditions;
- background processes of the cervix (erosion, leukoplakia, ectropion and others);
- hormonal changes (pregnancy, premenopausal, hormonal contraceptive pill);
- immunodeficiency (chronic stress, treatment with antibiotics and other medications, with HIV-infection).
Symptoms of cervical dysplasia
Typically, dysplasia of mild to moderate clinically not manifest itself. Approximately one in ten women the disease is hidden.
The symptoms of the pathological process manifest in severe dysplasia or accession secondary infection (coleitis, cervicitis).
Characterized by signs of inflammation:
- itching and burning of the external genitalia,
- pain during intercourse,
- profuse discharge from the genital tract with an unpleasant odor.
Moreover, there are contact spotting (after intimacy, gynecological examination, douches). In severe cervical dysplasia may be aching pain in the lower abdomen.
Without treatment, the process progresses with time and mild dysplasia flows into the heavy phase, and then into squamous cell carcinoma.
Diagnostics
Examination for cervical dysplasia includes a number of instrumental and laboratory tests, which give the opportunity to confirm or refute the diagnosis. By visual examination of the cervix in the mirror often, there are no visible changes.
Basic examination methods:
- colposcopy - This examination of the cervix by a special device (colposcope) at a magnification of 10 times or more. Colposcopy is absolutely safe and painless procedure.
- Cytology - is held annually as a prophylactic measure for all women and reveals abnormal cells and epithelial cells, markers of human papillomavirus infection.
- Biopsy - with the most suspicious cervical area under the control of excised tissue piece colposcopy for further histological examination. Histological examination of the most reliable method of diagnosis in 100% of cases confirms the diagnosis.
- The PCR method (polymerase chain reaction) - is the most reliable method for determining HPV in any bodily fluid (blood, urine, mucus).
Treatment of cervical dysplasia
Tactics physician in choosing a method of treatment depends on the patient's age, pathological nidus size, presence of concomitant diseases, degree of dysplasia.
In some cases, the disease is not conducted therapy:
- age 20 years or younger;
- pinpoint lesions of the mucous of the cervix;
- dysplasia has not spread into the cervical canal;
- lack of HPV infection.
When detecting HPV is pre antiviral therapy followed by colposcopy (often after treatment dysplasia disappears or becomes lighter degree).
In this case shows the monitoring and delivery of smears on cytology every 3-4 months.
Dysplasia grade 1-2 cures local gynecologist and severe dysplasia oversees gynecologist-oncologist.
Surgical treatment of dysplasia
Surgical treatment dysplasia held in the first phase of the menstrual cycle (day 6-10) and in the absence of inflammation.
Necessary tests:
- Pap smear (less than 6 months)
- vaginal smear on the degree of purity (less than 10 days)
- tests for infection, sexually transmitted (chlamydia, ureaplasmosis, Mycoplasmosis).
methods:
- diathermocoagulation (cauterization and / or excision of pathological nidus through electrical current);
- cryotherapy (destruction hearth dysplasia liquid nitrogen);
- lazerovaporizatsiya - the method is based on the effects of low-intensity laser beam on the damaged cervical center uterine, whereby the pathological tissues are destroyed by heating, forming necrotic zone at the junction with healthy cloth;
- knife cervical conization - surgery, during which the cervix is removed conical portion (typically, a loop is performed after diatermokoagulyatora analgesia);
- cervical amputation.
Contraindications to surgical treatment:
- pregnancy;
- adenocarcinoma;
- cervical and vaginal infection;
- inflammatory diseases of the pelvic organs.
After operation
In the postoperative period may be aching pain in the lower abdomen, and copious mucous discharge from the genital tract. As the temperature increases, the occurrence of bleeding is an urgent need to see a doctor.
the patient recommend
- to refrain from sexual activity 4-6 weeks
- limit the heavy lifting,
- not visit the bath and sauna, not to take a bath,
- do not use tampons or douche.
The recovery period is 4 - 6 weeks.
After 3 months, the test is conducted colposcopy and cytology smears. If negative, the woman is removed from the dispensary in a year.
Complications of surgery
- menstrual disorders;
- scar cervical strain;
- relapse (incomplete or inaccurate inspection);
- exacerbation of chronic inflammatory diseases of the pelvic organs;
- infertility.
Complications during or after surgery are rare and depend on the complexity of procedures, conditions of its performance, the doctor qualifications and compliance with the recommendations of the patients in the postoperative period.
