Cervical dysplasia is not simply attributed to the pathology of the reproductive system, but to precancerous conditions.Its danger is that under often unrefined symptoms, there is a potential danger and a high risk of cervical cancer.
Dysplasia is a structural pathological change 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 sooner a dysplasia is detected, the less is the risk of the process turning into a cancerous one.The prognosis always in this case depends on the degree of dysplasia of the cervix.
Note: degeneration of ordinary cells epithelium cervical pathology occurs gradually: hyperplasia, proliferation, impaired cell differentiation and the processes of their physiological maturation and aging.Contents: Causes of cervical dysplasia Cervical dysplasia:
degrees Causes of cervical dysplasia
Specialists are 98% confident that the cause of this pathology is the long stay of papillomovirus( oncogenic types 16 and 18)In the mucous membrane of the cervix.It is enough 12-18 months for the virus to provoke dysplasia.Among the factors that increase the risk of its formation, the following are distinguished:
- frequent abortions;
- hormonal imbalance in the body( hormonal contraceptives, premenopause);
- infections of sexual organs of a chronic nature;
- earlier onset of sexual activity;
- poor nutrition;
- genetic predisposition;
- mechanical trauma to the mucous neck;
- promiscuous sexual intercourse;
- high parity( many kinds in the anamnesis);
- member head cancer;
- background pathological processes on the cervix of the uterus( ectopia, erosion, ectropion);
- delivery at an early age;
- lowering the body's immune forces against the background of stress, systemic pathologies, taking certain drugs.
degrees In official medicine, dysplasia of the cervix is commonly referred to as intraepithelial cervical neoplasia( CIN is the Latin abbreviation for the name).Classify it taking into account the presence of atypical cells in the smear, which is taken by a gynecologist from the surface of the cervical epithelium.
The degree of dysplasia is determined on the basis of such characteristics as :
- the penetration depth of cellular modifications into epithelial layers;
- structure of altered tissues;
- morphology of the pathological site.
A healthy mucosa has 4 layers that are affected depending on the degree of dysplasia.
Important : statistics state that 25% of women have cervical pathology, in 40% of cases it is detected in pregnant women and 20% in non-pregnant women.
Cervical dysplasia of the 1st degree( weak)
The following changes are determined in it :
- not expressed modification of the basal layer;
- symptoms of the presence of papillomavirus - dyskeratosis and koylocytosis in analyzes;
- changes penetrate to a depth of at least 1/3 of a third of the epithelium.
Cervical dysplasia of the 2nd degree( medium)
It is diagnosed with deeper changes in the structure of the tissues :
- severe structural lesions;
- pathological process affects ½ of the epithelium;
- morphological changes at the cell level progress.
Cervical dysplasia of 3 degrees( severe)
For this degree of dysplasia, the process spreads as deeply as possible :
- with her atypical lesions are marked on 2/3 of the mucous membrane of the cervix;
- strongly pronounced structural changes;
- there is pathological mitosis of cells;
- in cells reveal hyperchromic nuclei of large size;
- pathological cells exist exclusively in the mucosa and will not spread to vessels, muscles, and adjacent tissues.
Cervical dysplasia: symptoms
A typical clinical picture will last in most cases already in severe dysplasia of the cervix and the attachment of a secondary infection( cervicitis, colpitis).A woman may not even guess about this disease, sometimes changes on the neck can not be seen and the gynecologist when examined, or they are insignificant.That is why it is important to undergo scheduled examinations every six months, because the most informative way of diagnosis is cervical smears, which are taken during each visit to the doctor.A patient with dysplasia of the cervix can present the following complaints:
- , if they are secretions( abundant with an unpleasant odor);
- pains on the background of adnexitis;
- spotting( often contact, that is, after intercourse, gynecological examination);
- burning sensation;
- pain arising during sex.
Important : , the presence of such symptoms for cervical dysplasia is an urgent reason to seek medical help.Without appropriate therapy, the disease will progress and may pass into squamous cell carcinoma.
It is not superfluous to repeat that the most important rule that a woman should adhere to is a scheduled visit to a gynecologist every 6 months and unscheduled for any anxiety or troublesome symptoms.This allows time to identify pathological changes and start treatment on time.The diagnostic plan for suspected cervical dysplasia includes:
- Gynecological examination.It is performed using gynecological mirrors.During the course of the doctor discovers a visually noticeable discoloration of the mucosa, gloss around the cervical cervical pharynx, atypical proliferation of the epithelial layer, spots.
- Instrumental Research .
- Colposcopy - targeted examination of the pathological sections of the neck using an optical device - the colposcope.The procedure itself is completely safe and painless for a woman.To see those defects that are invisible to the naked eye, the neck is treated with acetic acid or Lugol's solution.Thanks to them, the vessels narrow, and the doctor receives an enlarged colposcopic picture.
- Cervicography is a method of obtaining cervical images by using a special camera.The results obtained can only be deciphered by a specialist.
- A sighting biopsy is the lifetime taking of a small area of tissue from that neck zone, which has the most radical changes in the structure.
- Laboratory testing:
- Cytology of the smear from the neck.She is held by a woman at each scheduled visit to the doctor.The main task of this analysis is the timely diagnosis of the appearance of any atypical cells in the epithelium.
- Investigation of the histological structure of tissue particles.It is the most informative in terms of diagnosing dysplasia.
- The PCR method is a test that can detect the presence of oncogenic types of the papilloma virus in the body.
Treatment of cervical dysplasia
For dysplasia of the cervix, treatment with and treatment methods depend on certain factors :
- age of the woman;
- degree of dysplasia;
- the size of the pathological site;
- Concomitant diseases;
- desire to have children in the future.
Treatment of cervical dysplasia of grade 3, the most severe, should be done by a gynecologist-oncologist, applying exclusively surgical techniques.1 and 2 stages of dysplasia are treated by the local gynecologist.A woman with confirmed dysplasia of the cervix is necessarily placed on a dispensary record.At a young age of the patient and І, ІІ degrees of dysplasia, a small area of lesion, the use of expectant management is possible.At this time, the doctor observes the condition of the woman and the condition of dysplasia, which can progress or regress.
There are certain cases when it is not advisable to treat with cervical dysplasia :
- a young woman's age( less than 20 years);
- absence of papillomavirus infection in the body;
- dysplasia without spreading to the cervical canal;
- Dysplasia of the epithelium of the cervix in a point type.
Currently, the following therapy methods are used:
- is a medicament.
It includes drugs to improve immunity in the form of immunomodulators, as well as interferon.They are used for extensive lesions and recurrent form of dysplasia.
Note: in the case of the definition of the papilloma virus in the body, a woman is prescribed antiviral therapy.Very often after such treatment, dysplasia itself disappears or regresses into a lighter stage.
Surgical treatment of cervical dysplasia
It is used in case of a double positive test result for dysplasia.Before any surgical procedure, anti-inflammatory drugs are prescribed for the sanation of the focus.Very often after preoperative treatment, the degree of dysplasia is reduced in size or completely disappears.Operations always perform in the first phase of the monthly cycle, namely on the 6-10th day, provided there is no inflammation in the vagina and uterus, and pregnancy.
Modern surgical techniques for the treatment of cervical dysplasia are as follows:
- Laser surgery( laser vaporization, laser conization, laser cautery).This is a method of affecting pathological tissues by means of a laser beam with a low intensity.Due to this, the areas of dysplasia become heated and destroyed, necrosis is formed in their place.
- Cold destruction( cryodestruction, cryoconification).
- Electrical excision( diathermocoagulation, loop electric excision procedure).
- Conization of the cervix.With her special knife in the form of a loop, remove the section of the neck of a conical shape.
- Cryotherapy.This technology provides for liquidation of the focus on the neck with liquid nitrogen.
- Radio wave surgery.
- Amputation of the cervix.Radical removal of the neck if it is impossible to conduct or ineffectiveness of other methods.
After surgical therapy, a woman must adhere to some medical recommendations:
- rejection of sexual activity for 1-1.5 months;
- does not lift weights;
- does not perform douching;
- do not use tampons;
- does not go to the sauna and bath.
At the expiration of 3 months, a woman must carry out repeated colposcopy and take a smear from the cervix for cytology.If everything is normal, it is removed from the medical examination.Rarely, but after surgery for the removal of dysplasia, such complications can develop:
- transition to the stage of exacerbation of chronic inflammation in the small pelvis;
- scars on the neck;
- dysmenorrhea( impaired menstrual function).
Prevention of cervical dysplasia
To prevent the development of this pathology, one should adhere to certain recommendations:
- mandatory use of barrier contraceptives in case of accidental sexual intercourse;
- timely detection and treatment of inflammatory and infectious diseases of the reproductive system;
- enriching the diet with foods high in micronutrients and vitamins;
- regular visit to the gynecologist.
The most progressive methods of treating cervical dysplasia are described in detail in this video review:Viktorova Julia, Obstetrician-Gynecologist