Symptoms of cervical dysplasia and methods of treating pathology

• Cervical dysplasia is one of the most serious diseases of the female genital area, which is a harbinger of the oncological process.
• Therefore, this pathology must be monitored by a competent specialist, as well as promptly and correctly treated.
• According to statistical data, cervical dysplasia is most often diagnosed in women of the reproductive period.
• However, this disease can also occur in more mature women.

What is dysplasia?

Cervical dysplasia is a process that is accompanied by the degeneration of epithelial cells lining the mucous membrane of the cervical region.

The cervix (vaginal part) has three layers - superficial, middle and basal. In the basal layer, new cells are formed, which have a round shape and one nucleus.

After maturation, the formed cells move to the upper layer, while the size of the nucleus decreases, and the cells themselves flatten.

When dysplasia develops, the cells do not flatten, but enlarge or lose their shape, in addition, the number of nuclei may change upward. That is, atypia occurs, which causes loss of epithelial layering.

1. Depending on the depth of spread of the pathological process and the intensity of cellular changes, dysplasia is divided into 1, 2 and 3.
2. Dysplasia in its manifestations is similar to erosive lesions of the uterus, but unlike it, with dysplasia, changes occur at the cellular level, while erosion is associated with mechanical damage to soft tissues.
3. Dysplasia is a serious and quite dangerous disease that leads to the development of oncological processes in the cervix, and as you know, cervical cancer is considered the most common oncological disease affecting the fair half of humanity.

Causes

• The main cause of dysplasia is the effect of human papillomavirus on the cervical mucosa.
• The most dangerous are its oncogenic strains - 16 and 18.
• When this virus is on the mucous membrane for a long time, it gradually integrates into epithelial cells and changes their structure; the following factors can provoke this process:

• smoking;
• low immunity;
• inflammatory and infectious processes in the vagina;
• mechanical damage to the mucous membrane of the neck;
• early onset of sexual activity, early or traumatic birth;
• hormone imbalance;
• frequent change of sexual partners;
• presence of genital cancer in the sexual partner.

Degrees of the disease

As already mentioned, dysplasia is divided into stages according to the depth of penetration of the pathological process and the nature of cell changes.

According to the international classification of the disease, the following three degrees of the disease are distinguished::

1. The first degree is a mild degree of the disease, in which pathological processes can be observed exclusively in the lower part of the epithelial layer. Cellular changes are not yet clearly visible; mitotic activity and some polymorphism of cellular structures and their nuclei are noted. The basal and peribasal layers are somewhat hyperplastic.
2. The second degree is moderate dysplasia. Structural cellular changes affect not only the lower, but the middle part of the epithelial layer. In the affected part, oval cells are observed, there are mitoses (cell division), including pathological ones. The epithelial cells adhere tightly to each other, there is a slight pathological shift in the structure of the nucleus - coarsening of the chromatin structure, an increase in the size of the nucleus.
3. The third degree of dysplasia is considered the most severe. In fact, this is already a non-invasive cancer. Atypical changes are observed throughout the entire thickness of the epithelial layer. But other tissues - blood vessels, muscles, nerves - are not yet affected. If this occurs, the disease is considered to have transformed into malignancy and the cancer has become invasive. In the 3rd degree of dysplasia, there are mitoses, the nuclei greatly increase and change shape, there is polymorphism of the nuclei, as well as a cytoplasmic shift. Huge cells with very large holes begin to appear. But the cell boundaries continue to remain clear.

1. It must be said that grade 1 dysplasia in half of the cases can go away on its own after the complete elimination of the papilloma virus.
2. In 35% of cases, the disease becomes chronic, that is, the disease does not regress, but does not progress, and in 10% of cases, dysplasia progresses to degree 2.
3. The second degree of dysplasia can also occur without medical intervention, but the percentage of such cases is already lower - 30-40%.
4. With adequate antiviral therapy, the disease recedes in 70%; the disease progresses to stage 3 in 25% of cases..
5. The third degree of dysplasia is transformed into a malignant formation in 10-35% of cases - this depends on the individual characteristics of the patient - age, number of sexual partners, bad habits, background illnesses, etc.

Symptoms of the disease

• The insidiousness of dysplasia in the absence of a pronounced clinical picture.
• A mild degree of dysplasia generally occurs without any symptoms, which leads to the fact that dysplasia is most often diagnosed in an advanced form.
• In this regard, gynecologists convince women to come for routine examinations regularly so as not to miss the onset of a dangerous illness.
• In advanced stages, dysplasia may be accompanied:

• painful sensations during intimacy;
• bloody discharge after sexual intercourse;
• itching and burning in the vaginal area;
• disruption of the menstrual cycle;
• an increase in the amount of leucorrhoea.

This symptomatology is characteristic of a large number of gynecological ailments; as for specific symptoms of dysplasia, there are none . The signs listed above only indicate the presence of problems in the genital area, and to clarify the diagnosis you need to undergo an examination.

Dysplasia, as a rule, occurs in a latent form, but even if it is accompanied by any symptoms, it is impossible to diagnose the disease using them alone. Most often, such symptoms are accompanied by colpitis, cervicitis, infectious diseases, inflammation, and erosion.

As for any specific pain, characteristic discharge or other manifestations indicating dysplasia, there are none, so diagnosis and medical consultation are necessary. The only thing that can be said about the clinic of dysplasia is that this disease quite often occurs against the background of chlamydia, gonorrhea and other infectious diseases.

Therefore, in the presence of such diseases, a woman should take preventive examinations by a gynecologist more seriously.

What is the threat of the disease?

Of course, each degree of dysplasia carries one or another danger to a woman’s health, but the biggest threat is the transformation of the disease into a malignant process.

In addition, against the background of dysplasia, inflammatory processes may begin to develop, and if the mucosa is damaged, infectious agents may penetrate into the deep layers of the cervix.

Diagnostic methods

Diagnosis of dysplasia is carried out comprehensively, it includes :

1. Colposcopy – instrumental examination using an optical device that visualizes the cervical mucosa at 30x magnification. This examination is carried out in several stages.

   First, the cervical mucosa is treated with a vinegar solution, then it is treated with iodine or Lugol's solution, and only then the doctor begins to examine the epithelium. Such preparatory measures are necessary so that healthy areas become colored due to the presence of glycogen granules in them, while the affected areas remain discolored.

2. Scraping . If the pathological focus is located in the cervical canal, curettage may be required to obtain biomaterial for subsequent laboratory analysis.
3. Smear cytology.

   This analysis reveals the presence of irregularly shaped cell nuclei, uneven distribution of chromatin, an increase in nuclear size and other signs characteristic of this disease.

4. Biopsy. This is a very informative and one of the most reliable analyzes that reveals the presence of atypical and oncological cellular structures in tissues.

   Thanks to this examination, it is possible not only to detect the fact of dysplasia, but also to determine its degree.

1. In addition, the doctor can refer the patient for a general clinical blood test, a blood test for sex hormones, as well as a smear culture for an infectious pathogen.

2. One of the important tests in diagnosing dysplasia is PCR analysis, which allows you to determine the presence of the papilloma virus and determine its strain.
3. Only after processing all the data received can a specialist make a diagnosis of dysplasia and determine its degree.

4. When it comes to instrumental examination of virgins, colposcopy is not used.
5. In this case, the emphasis is on ultrasound, and it is possible not only through an abdominal examination, but also a transrectal one, which will be more informative.

Treatment Options

Treatment for dysplasia is not prescribed in all cases; sometimes simply immunostimulation is enough, after which the body begins to independently suppress the papilloma virus, which leads to the elimination of the disease .

In stages 1 and 2 of dysplasia, doctors most often resort to conservative methods, and may also advise their patients to use traditional medicine as additional therapy.

As for drug treatment, they are prescribed:

• antiviral drugs;
• antibacterial agents;
• immunostimulants.

Sometimes such therapy is enough for the pathological process to regress.

Pathological tissue can be removed in the following ways:

• cryodestruction – freezing with liquid nitrogen;
• laser cauterization - exposure of the affected areas to laser beams;
• radio wave treatment – ​​removal of affected areas using radio waves;
• electrocoagulation – elimination of pathological tissues with electric current.

• If the disease is diagnosed as severe, and also if the doctor has real concerns that the disease is beginning to transform into oncology, coniation of the cervix or complete amputation of the damaged organ may be required.
• This surgical intervention can be performed using a scalpel, or modern methods can be used - cryodestruction, radio wave excision, laser removal.
• Each of these methods has its positive and negative sides, and only a doctor can choose the optimal method, based on the woman’s age, the individual characteristics of her body, the degree of the disease, and other things.
• After amputation of the cervix, a woman’s reproductive function is preserved, but the doctor must be informed about her plans for a future pregnancy in advance so that the most gentle method for removing the cervix can be selected .

Conclusion and conclusions

1. Dysplasia is a precancerous condition that requires very serious treatment.
2. A woman should unquestioningly follow the specialist’s recommendations, not attempt self-medication, come for follow-up examinations in a timely manner and get rid of bad habits.
3. This is the only way to prevent dysplasia from degenerating into a deadly disease..

Source: https://zhenskoe-zdorovye.com/ginekologija/bolezni-matki/displaziya-shejki/simptomy-u-zhenshchin.html

Cervical dysplasia: 1, 2, 3 degrees, treatment, forecasts and reviews

Cervical dysplasia is a precancerous condition, a disruption of the process of production and division of cells, their gradual degeneration into pathological ones. The disease is somewhat reminiscent of erosion.

The main difference is the initial stage of tumor development. Only timely detection of the disease guarantees a complete cure for this disease. It is in women of reproductive age that this diagnosis is often made.

The prognosis will directly depend on the severity of the development of this disease.

What is cervical dysplasia?

Cervical dysplasia is an anomaly of structural tissue cells in the vaginal mucosa, the initial stage of degeneration into cancer, and this is already a fatal pathology. If intensive timely therapy is not started, epithelial cells will become susceptible to abnormal changes and irreversible processes.

The vaginal part contains many layers of squamous epithelium, among them:

• superficial, composed of epithelium , which gradually begins to die off, being replaced by connective tissue;
• basal (middle) layer with the presence of cells subject to structural modifications, acquisition of shapeless large sizes with many nuclei, erasure of layers, degeneration of normal cells into pathological ones, unable to independently renew or function;
• parabasal as a deeper layer with an arrangement of several muscular layers of tissue capable of desquamation.

The cells begin to gradually shrink, and the nuclei begin to decrease in size.

Causes of dysplasia

Women are advised to vigilantly monitor the condition of their genitals and their well-being. It is the provoking factors that contribute to the development of dysplasia. The appearance of unpleasant signs is a clear signal of problems in the sexual sphere. It is possible that this is already an advanced stage of the disease.

Dysplasia can be caused by:

• birth process;
• bad ecology;
• hereditary factor;
• immunodeficiency;
• metaplasia;
• diseases with an inflammatory course;
• bad habits (alcohol, smoking);
• HPV (strains 16, 18) as the main provocateur of the development of dysplasia;
• hormonal disbalance;
• early onset of sexual activity;
• promiscuity;
• abuse of synthetic hormones;
• decreased local immunity;
• hormonal dysfunction, which occurs in girls during adolescence;
• pregnancy, involution period;
• artificial interruption, abortion;
• trauma of the birth canal;
• lesions of the labia, vaginal walls with condylomas;
• deficiency of vitamins, folic acid, beta carotene in the body;
• passive smoking;
• sexual relations with men who are carriers of a tumor of the head of the penis with accumulation of smegma in the lower part of the foreskin with the presence of carcinogenic properties.

According to statistics, the risk group consists of young women under 30 who neglect personal hygiene products and have bad habits.

Usually in a healthy body the virus does not linger for long and is eliminated from the body on its own within 8 months.

Its presence in the body for more than 3 years leads to the opposite effect - the development of 1st degree dysplasia with a gradual transition, first to a moderate, then to a severe stage.

It is HPV that is the most important enemy, fraught with the development of cervical dysplasia. Prognosis will depend entirely on timely treatment and the use of effective techniques.

Types of cervical dysplasia

Dysplasia, Latin abbreviation - cervical neoplasia is detected taking into account the classification and the presence of atypical cells in a smear (taken from the surface of the epithelium). The diagnosis is established based on the results of a histological examination, taking into account the number of layers with cells susceptible to epithelialization.

According to the types of dysplasia there are:

• primary in case of detection of atypical cells affecting 1/3 of the thickness of the epithelial layer;
• secondary moderate with damage to the layer by more than 2/3 of the thickness;
• advanced severe form with damage to most of the epithelial layer with involvement of the basement membrane, other layers with mature epithelial cells, in particular, the normal structures of the cervical canal.

Dysplasia in its advanced form is difficult to differentiate when not only the upper part of the vaginal cervix is ​​affected by pathology, but also the internal canal of the cervix.

Degrees of the disease

During histology, the degree of dysplasia is determined by doctors taking into account the depth of damage to the epithelial layers by pathogenic cells, the structure of tissue modification, and the morphology of the pathological site.

Normally, the healthy mucous membrane of the uterine cavity consists of 4 layers, each of which can be susceptible to damage, depending on which doctors determine the degree of dysplasia:

1. 1 weak degree - the initial stage of pathology with an implicit modification of the basal layer of the epithelium, the absence of symptoms and even papillomavirus is not detected in the diagnostic tests. Damage to the epithelium in depth - not deep, amounts to no more than 1/3 of the entire surface of the epithelial layer
2. 2nd degree with modification of the structure of deeper tissues, when damage to the structures is clearly expressed, almost half of the epithelial layer is involved in the pathology. Cell changes begin to progress already at the morphological level.
3. Grade 3 is advanced and is considered the most severe, when deeper layers are affected by dysplasia. An atypical lesion is observed on more than 2/3 of the mucous membrane of the cervix. Structural changes are clearly expressed. Cell mitosis progresses, large large hyperchromic nuclei are revealed. Although the vessels, neighboring tissues and muscles may not be affected by the pathology.

The degree of dysplasia is determined by examining a smear for cytology and performing a biopsy. Based on the results of these tests, an accurate diagnosis is established.

Symptoms and signs of dysplasia

At risk are young women (15-25 years old) who have early sexual activity, when after 2-3 years HPV is detected in 82% of cases. Although, of course, the infection does not always become malignant. The picture becomes more clear already at a late stage of development of the pathology.

At stages 1-2, there may be no symptoms at all, and only a random visit to a gynecologist or a routine examination will help identify problems at the initial stage.

IMPORTANT! Women need to undergo a routine examination by a gynecologist at least twice a year and take a cervical vaginal smear.

Signs of dysplasia are obvious:

• itching, burning;
• pain in the vagina during sexual intercourse;
• discharge of bloody discharge upon palpation, after examination by a gynecologist;
• signs of vaginitis, adnexitis, accompanied by obvious pain;
• discharge of leucorrhoea, discharge with an unpleasant putrid odor
• disruption of the menstrual cycle;
• temperature rise to high values;
• nagging pain in the lower abdomen.

On a note! Such manifestations can no longer be ignored. This should be a reason for urgent medical attention. If left untreated, the pathology will quickly begin to progress and it is quite possible that the vaginal mucosa will degenerate into a squamous cell tumor.

Symptoms of dysplasia are similar to PMS at the initial stage. Visible changes on the genital organs may not be observed, and the pathology does not always have an independent course. As a rule, it develops against the background of other concomitant infections with viruses, bacteria, chlamydia, genital warts, gonorrhea, and syphilis.

Often, pathology is detected with the onset of pregnancy in women, when the question arises of urgent treatment, taking into account the degree of risk and negative impact on the fetus.

Dysplasia is often provoked by a microbial infection with the appearance of signs of cervicitis, colpitis, itching and burning in the genital tract, discharge of serous discharge mixed with blood against the background of inflammation. Cervical dysplasia begins to regress and becomes protracted.

Attention! At the 3rd, advanced stage, almost the entire thickness of the epithelial layer can be subject to pathological changes. In this case, non-invasive cancer is diagnosed. It is this form that can remain in a latent state for up to 25 years, without making itself known in any way. Only a timely examination by a gynecologist will allow the pathology to be identified at an early stage.

Diagnostic methods

• Detection of pathological changes in the uterine cavity begins with a visual gynecological examination by a doctor using special mirrors.
• It is possible to immediately visually detect a change in the color of the uterine mucosa, the appearance of a specific shine around the throat of the cervix, atypical growths or spots in the epithelial layers.
• Diagnostics is carried out using instrumental methods:

• cervical biopsy by removing a tissue sample from the cervix for examination;
• cervicography by taking an image using a special camera from the uterine cavity and then interpreting the results
• targeted biopsy by taking tissue from the cervical area to study for changes in structure;
• colposcopy as a targeted method of examination using a colposcope, allowing to identify even minor, barely noticeable defects.

On a note! Examination of the cervix and vagina is carried out only in a supine position, which is important for patients to know when visiting a gynecologist’s office.

Laboratory research methods include:

• PCR as one of the main methods for identifying oncogenic papillomavirus (16, 18);
• histology as a study of the structure of epithelial tissue particles, an informative method for deciphering dysplasia;
• cytology by taking a smear from the cervix to identify atypical cells in the layers of the uterine epithelium.

Consequences of cervical dysplasia

Complications of dysplasia can be:

• bleeding after surgery;
• narrowing of the lumen of the cervix due to the addition of another infection.

The consequences of dysplasia can be disastrous, why is it so important to identify the pathology at an early stage:

• Of course, at stage 1 the prognosis is favorable and it is enough to complete a course of treatment with medications, in addition - folk remedies.
• It is already difficult to suppress a pathogenic virus in the body at stage 2 of dysplasia on your own . In order to recover, women will have to be treated with medications for quite a long time, 2-3 years, while keeping their condition under control and being registered with a gynecologist.
• Stage 3 – advanced , with the appearance of cancer cells and metastases – a precancerous condition. It threatens the development of oncology when doctors make the only right decision - removal of the cervix; the operation can be performed together with the ovaries if they are involved in the pathological process.

Attention! Signs of dysplasia become obvious only at the 2-3 stages of development. Women should not ignore the appearance of even minor unpleasant signs.

During the recovery period, it is impossible to do without correction of the structures of the reproductive system. The chances of healing and revival of the cervix are low. Only a complete diagnosis and strict adherence to all doctors’ instructions will help avoid death.

On a note! Only vigilance and diligence of women will avoid the serious consequences of dysplasia, in particular cervical cancer, which is fraught with such pathology when the process starts.

Illness and pregnancy

At the initial stage, dysplasia does not pose any particular danger to pregnant women, but as it progresses it can have a detrimental effect on the child. It is pregnancy that leads to the suppression of the body’s immune forces, and therefore to the progression of the pathology.

The level of estrogen quickly begins to increase, due to which the cervical mucosa is subject to modifications. The inner epithelial layer is shortened and turned outward.

IMPORTANT! The progression of dysplasia during pregnancy can be triggered by an acidic environment in the vagina or the entry of a virus.          

Dysplasia after childbirth

1. Dysplasia itself cannot negatively affect the fetus.
2. Complications in the postpartum period, namely conization (gestation) of the cervix due to cesarean section and suturing, lead to serious consequences for the baby.
3. Complicated childbirth can have a detrimental effect on the newborn.
4. Especially if the lesions in the uterine cavity are quite extensive, bleeding of varying severity occurs.

Source: https://woman-centre.com/matka/displaziya-sheyki-matki.html

Cervical dysplasia - causes, symptoms and treatment

One of the most common precancerous forms in women is cervical dysplasia. It is detected in different age groups: from twenty-year-old girls to women in menopause.

This disease is based on structural changes in the epithelial layer of the cervix (atypical cells increase in volume, lose outline and grow), which are pathological in nature.

They are manifested by dysfunction of the processes of cell formation and rejection, as well as the presence of processes of cellular proliferation and restructuring that are uncharacteristic for this localization.

So, if erosion occurs as a result of mechanical injury to the mucous lining and does not affect its constituent cells, then uterine dysplasia is characterized by structural, atypical tissue restructuring, which can ultimately lead to oncology.

Due to the absence of pronounced symptoms, uterine dysplasia is detected only when a woman seeks consultation about another, concomitant disease. It is discovered during a gynecological examination.

If the disease is found in the early stages of development, then the chances of a complete recovery and prevention of cancer are high, however, if time is lost, it can only be resolved surgically.

The severity of this disease is directly dependent on the degree of damage to the epithelial lining:

• 1st degree cervical dysplasia - mild. Characterized by minor changes affecting the lower third of the epithelial layer;
• cervical dysplasia of the 2nd degree - a moderate, progressive stage of the disease, leading to morphological changes in 2/3 of the thickness of the epithelial lining;
• cervical dysplasia 3 degrees. This stage is characterized by the presence of pathological cellular changes throughout the entire thickness of the epithelial layer. This is a non-invasive cancer in which the affected cells do not grow into nearby tissues and blood vessels. Precancer can remain in this latent state for up to 20 years, and then turn into invasive cancer.

To protect your health from the possible occurrence of uterine dysplasia and more severe conditions, it is important for a woman to know the origins of this disease.

Causes of cervical dysplasia

In most cases known to modern medicine (up to 98%), the main cause of uterine dysplasia is the human papillomavirus, which is found in a woman and exists for a long time (more than 1 year) in the cervical mucosa, belonging to oncogenic types 16 and 18. The following predisposing factors aggravate this disease:

• smoking (is a catalyst for the development of uterine dysplasia, accelerating its development by 4 times);
• onset of early sexual activity (before 16 years of age);
• immunodeficiency caused by stress, poor nutrition, chronic diseases, drug abuse;
• a sexual partner has cancer of the head of the penis;
• traumatic effects on the cervix;
• early birth and in large quantities;
• promiscuous sexual relations (more than three partners);
• mechanical trauma to the uterine cavity through abortion and curettage;
• hereditary factor;
• sexually transmitted infectious diseases (gonorrhea, genital warts, chlamydia, etc.);
• hormonal changes due to pregnancy, a woman’s transition to premenopause;
• long-term (more than 5 years) use of combined hormonal contraceptives;
• deficiency of beta-carotene and vitamins A and C in the body;
• monotonous nutrition, poor in essential microelements;
• unsatisfactory social conditions;
• chronic gynecological diseases (ectropion, erosion, etc.);
• the woman has type 7 herpes;
• antisocial behavior;
• AIDS.

The presence of these factors accelerates the development of cervical dysplasia and helps catalyze its malignant course.

Symptoms of cervical dysplasia

Cervical dysplasia

In order to determine whether a woman has cervical dysplasia, it is important, first of all, to pay close attention to the symptoms associated with the disease.

However, the insidiousness of the disease in the early stages is that it is asymptomatic, so it is almost impossible to detect it at this stage.

Only with the combination of secondary infections, such as cervinitis and colpitis, as well as the development of a severe form of uterine dysplasia, can one judge the existence of the disease. Inflammatory symptoms:

• pain during sexual intercourse;
• copious secretion of milky, odorless leucorrhoea;
• itching and burning localized on the outer part of the genitals;
• vaginal discharge streaked with blood (after douching, sexual intercourse, using tampons, as well as a gynecological examination);
• aching pain in the lower abdomen.

And although the appearance of the above symptoms in a woman does not directly indicate the presence of uterine dysplasia, it is a signal for more careful monitoring of her health.

A big breakthrough has been made by medicine in highlighting the dominant role of HPV as the main source of dysplasia, which has made it possible to radically change the attitude of doctors towards methods that make it possible to successfully diagnose such a disease.

Diagnosis of the disease

To successfully diagnose dysplasia, due to the fact that its symptoms are mild, gynecologists use various methods: laboratory, instrumental and clinical. The main diagnostic techniques for detecting a disease such as cervical dysplasia are:

• examination of the vaginal mucosa using speculum. Using this study, you can visually assess the color of the mucous membranes, detect areas of growth of squamous epithelium, and also visualize pathological spots and shine near the external pharynx;
• PCR diagnostics. With its help, you can accurately determine the presence of HPV in any physiological fluid of the body (mucus, urine or blood);
• colposcopy. Through the use of a colposcope, which magnifies the image of the mucous membrane tenfold, moderate and severe uterine dysplasia is detected. When Lugol's solution or acetic acid is applied to the mucous membrane lining the cervix, hidden defects appear that are not noticeable during a routine examination;
• cytological examination of a smear taken from the surface of the cervix. This study is carried out using a microscope. It allows you to identify HPV markers and the presence of atypical cells;
• targeted biopsy for the purpose of further histological examination of the excised suspicious area of ​​tissue. When identifying dysplasia, this method is the most informative.

Cervical biopsy

It should be noted that close monitoring of the state of women’s health and timely contact with a gynecologist can radically change the picture of the development of the disease and simplify the methods and tools of its treatment.

Treatment of cervical dysplasia

Although cervical dysplasia, as a disease, is progressive and protracted, with adequate treatment it tends to gradually regress. Therefore, it is important to begin treatment as early as possible when this disease is detected.

Treatment of cervical dysplasia is inpatient, carried out in a medical institution by a gynecologist and depends on a number of conditions:

• degree of dysplasia;
• age indicator of the patient;
• presence of concurrent diseases;
• size of the area of ​​pathological lesion;
• desire to preserve the function of childbearing.

Contraindications for therapy aimed at eliminating dysplasia are: the patient has not reached the age of 20 years, the woman does not have HPV, the presence of lesions of the cervical mucosa that are point-like in nature, as well as symptoms of uterine dysplasia absent in the cervical canal.

In modern medical practice, mild cervical dysplasia is treated conservatively, including:

• gynecological examination for 2 years;
• smoking cessation;
• annual colposcopy and cytology analysis;
• selection of alternative contraceptives;
• STI treatment;
• therapy of diseases of the endocrine system.

Treatment of moderate and severe cervical dysplasia is carried out in two directions:

1. Immunostimulating therapy is indicated for widespread recurrent dysplasia. It includes taking various immunomodulators that increase the immune response;
2. Surgical intervention is performed in the first phase of the menstrual cycle, provided there are no inflammatory processes. Before the operation, the patient is prescribed tests for STIs, a cytological smear, and a smear illustrating the degree of cleanliness of the vagina.

Surgical intervention is carried out in two directions:

1. destruction of the affected area using:
• cryotherapy. By applying liquid nitrogen to the affected area of ​​the mucous membrane, the area affected by dysplasia is destroyed;
• diathermocoagulation. By applying electric current to the affected area, the effect of cauterization or excision of the source of the disease is achieved;
• laser vaporization. By exposure to a low-intensity laser beam on the affected area, destruction of pathological tissues is achieved (by heating them) with the subsequent formation of necrotic zones at their junctions with healthy areas;
2. surgical excision, carried out in the following areas:
 
• conization of the cervix. A cone-shaped section of the cervix is ​​removed using a diathermocoagulator loop;
• amputation of the cervix.

Conization of the cervix

Side effects that occur after surgery include increased secretion of vaginal mucus, bleeding and periodic aching pain localized in the lower abdomen, lasting from 3 to 5 days.

Postoperative recovery usually lasts about 4–6 weeks.

During this period, the patient is advised to refrain from lifting heavy objects, visiting baths and saunas, engaging in sexual activity, and is also prohibited from using hygienic tampons.

Complications are possible with any operation. In this case, they include:

• relapse of the disease;
• infertility;
• symptoms of menstrual irregularities;
• exacerbation of chronic diseases of the pelvic organs that have a chronic course;
• symptoms of cervical scarring.

And although the occurrence of the above complications is rare, their likelihood increases the faster the more complex the operation is and the lower the operating and qualification experience of the surgeon, as well as if the patient does not comply with the prescribed recommendations.

3 months after the operation, the woman needs to return to a medical facility for a follow-up colposcopy and a smear for cytological examination. If negative results are obtained, the woman is removed from the register after a year.

For a patient who has suffered from this disease, it is important to follow preventive measures, which include:

• enrichment of the diet with vitamins A and B;
• to give up smoking;
• immediate treatment of infectious diseases;
• undergoing regular gynecological examinations;
• use of barrier contraception.

Compliance with these preventive measures in combination with early detection and timely treatment of uterine dysplasia gives a positive prognosis and reduces the likelihood of relapses and the development of non-invasive forms of cancer.

Source: https://SimptoMer.ru/bolezni/zhenskie-zabolevaniya/498-displaziya-sheyki-matki-simptomy

Cervical dysplasia - what are women afraid of?

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The diagnosis of “ cervical dysplasia ” is very frightening for women, because many know that this is a precancerous condition.

The problem is really serious, but it still shouldn’t be called fatal. First of all, it's not cancer yet. And secondly, cervical dysplasia can be successfully treated, and an experienced doctor will prescribe you effective therapy. Let's look at this problem.

What is dysplasia, where does it come from, how to diagnose and treat it.

Structure of the cervix

In order to understand what processes occur during dysplasia, you need to know how the cervix is ​​normally structured. In this case, we are interested in its microscopic structure, since changes in cervical dysplasia occur at the cellular level.

The cervix is ​​a narrow part of the uterus, part of which is located in the uterus, and the other part is located in the vagina. It is cylindrical in shape with the cervical canal inside. The cervix mainly consists of muscle tissue covered with epithelium. It is important that its structure in different parts of the neck is not the same.

The vaginal area is covered with stratified squamous epithelium, which performs a protective function. It recovers quickly from injuries and is resistant to acidic environments. The cervical canal is covered with columnar epithelium, the main task of which is to produce mucus.

So, the structure of the epithelium of the cervix in its different parts is different. And there is a place where the columnar epithelium transitions into flat epithelium, or, in medical terms, a transformation zone . This is the most vulnerable place, and during colposcopy the doctor must examine it and take a smear.

By the way, when describing an examination in a medical record or in other official documents, the definition of “transformation zone” sometimes causes certain phobias in patients. Associations with the oncological process arise.

In this case, we are not talking about the appearance of atypical cells; this is just one of the structures of the normal anatomical structure of the cervix.

Important question. Why exactly the epithelial transformation zone requires a thorough examination by a gynecologist? Looking ahead a little, it should be noted that dysplasia does not occur on its own.

It is caused by viruses that actively reproduce in the basal (lowest) layer of the epithelium. Access to it in other sections is protected by several layers of cells.

And in the zone of transition between columnar epithelium and flat epithelium, the cells of the basal layer are practically on the surface, and the virus naturally chooses the simplest path.

Causes of cervical dysplasia

Cervical dysplasia is caused by the human papillomavirus (HPV) . Not all viruses of this group lead to the appearance of cervical dysplasia. About 200 types (strains) have been studied, most of which are absolutely harmless.

That is, our immune system successfully destroys them without any consequences for the body. Some human papillomaviruses lead to the formation of genital warts on the genitals, while others cause the formation of papillomas on the skin.

These are benign neoplasms that bring physical and aesthetic discomfort, and rarely lead to more serious pathology.

Cervical dysplasia can be caused by the following strains of the human papillomavirus:

• With a high oncogenic risk (18, 16, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59);
• With low oncogenic risk (6, 11, 32, 40-44, 72).

Most often, the disease is caused by strains 16 and 18. They are diagnosed in approximately 70% of sick women.

If you are diagnosed with these viruses, this does not mean that you have dysplasia. And it’s not a fact that you will get sick in the future.

Everything largely depends on the state of immunity, the presence of concomitant diseases and lifestyle. Immunity is weakened by infectious diseases, hormonal imbalances, metabolic disorders, stress and smoking.

Therefore, take care of your health - this is the best prevention of cervical dysplasia.

Routes of transmission of human papillomavirus

In the vast majority of cases, the human papillomavirus is transmitted sexually from infected mucous membranes. That is, a woman (and a man too) can get an infection after the start of sexual activity. The probability of infection is quite high - about 60%. Thus, with unprotected sexual contact there is a greater chance of becoming infected than not becoming infected.

Men most often carry HPV and do not get sick. This is due to the structural features of the epithelium, and the genital organs in general. However, it is worth noting that sometimes dysplasia is diagnosed in men.

And unlike women, it is much more difficult to treat in representatives of the stronger sex. By the way, one of the methods of preventing cervical cancer in women is male circumcision.

There is also a vertical route of transmission of HPV (from mother to child) and contact-household transmission - through surgical and gynecological instruments, as well as from the patient to the medical staff during operations. But such situations are much less common, and the leading role in the development of cervical dysplasia is the sexual transmission of HPV.

What is cervical dysplasia?

Dysplasia is a change in the normal structure of cervical epithelial cells. Our cells are constantly dividing and renewing. These processes occur especially actively in places where tissue integrity is violated.

Simply put, microtraumas, irritations and cracks are the entrance gates of infection. The herpes simplex virus penetrates the cell nucleus and disrupts the chromosomal apparatus.

As a result, the next cell will differ from the previous one in structure, shape, nuclear size and functions.

Changed cells in dysplasia are not yet atypical. That is, dysplasia is like a transitional form between normal epithelium and cancer.

Depending on the degree of cell changes, there are 3 degrees of severity of cervical dysplasia. In medicine, dysplasia is called cervical intraepithelial neoplasia and is denoted by the abbreviation CIN:

CIN I (L-SIL)

Mild degree of dysplasia. The changes are weakly expressed in the basal layer of the epithelium.

• CIN II (H-SIL)
• Moderately severe dysplasia affecting half the thickness of the epithelial layer, starting from the basement membrane.
• CIN III (H-SIL)

Damage to more than 2/3 of the epithelial layer, with pronounced cell changes: the appearance of large nuclei, mitoses, etc.

In some magazines and online publications you can find pictures that demonstrate the severity of cervical dysplasia.

At the same time, grade 1 dysplasia looks like a small spot on the neck, while grade 3 dysplasia occupies almost half the area of ​​the organ. The visual size of the changed area does not always correspond to the severity of the process.

Many gynecologists have encountered the fact that a small, barely noticeable spot identified on colposcopy, upon in-depth examination turns out to be grade 3 dysplasia.

Symptoms of cervical dysplasia

The main problem is that dysplasia most often does not manifest itself at all. Minor nagging pain or bleeding after sexual intercourse is rarely observed. Sometimes there is a white discharge, which prompts the woman to consult a doctor.

Asymptomatic course is the main danger of cervical dysplasia. If a woman ignores visits to the gynecologist because “nothing hurts,” then this can end very badly.

This position of women is completely incomprehensible, because recently a lot of articles have been written about cervical cancer, information brochures have been published, and many programs and videos have been filmed.

Finding information is not a problem, if you have the desire.

Diagnosis of cervical dysplasia

To diagnose cervical dysplasia, the doctor performs standard procedures:

• Cytological examination of the cervical smear or the so-called PAP test. It is the “gold standard” in the diagnosis of dysplasia and cervical cancer. To do this, a scraping (a small amount of cervical cells) is taken with a special brush and sent to the laboratory. Here the doctor examines the cells under a microscope and determines the presence of changes.
• A blood test to determine HPV types using polymerase chain reaction (PCR).
• Colposcopy is performed using a special device (colposcope). Externally, it looks like binoculars and consists of an optical system for image magnification and a lighting device. With its help, the cervix is ​​examined and, if necessary, various manipulations are performed.
• Staining the cervix with a 3% vinegar solution and then with Lugol's solution.

A test with acetic acid makes it possible to determine the condition of the blood vessels. Healthy vessels should contract and decrease in size. Dilated vessels indicate their atypia.

Staining with Lugol's solution (Schiller test) depends on whether the cells contain glycogen. Normally, glycogen is present in the cells of the stratified squamous epithelium of the cervix in the vaginal area. Therefore, this area is painted brown.

Columnar epithelial cells, as well as cells that have undergone neoplastic processes, do not contain glycogen and are therefore iodine negative.

The presence of a light spot against the background of colored brown mucosa gives reason to suspect dysplasia.

• Biopsy. To do this, take a small section of the epithelium and examine it under a microscope. As a rule, a biopsy is taken during radical excision of an area of ​​altered epithelium.
• Curettage of the cervical canal with subsequent study of the resulting cells.

Treatment of cervical dysplasia

There is no specific treatment for cervical dysplasia. That is, there is not a single drug that can destroy the human papillomavirus and stop the process of changes in epithelial cells.

Drugs are prescribed depending on the situation. Treat concomitant infection, if any, and also carry out immunomodulatory therapy.

Taking into account the wary attitude of the modern medical community towards cervical cancer, many clinics recommend removing the altered tissue even with grade 1 dysplasia.

Surgical treatment of cervical dysplasia

The worst thing for women is, of course, surgical treatment, so let's talk in more detail about what it involves.

Contrary to fears, the procedure is painless. There may only be unpleasant but tolerable sensations. If you wish, your doctor may numb the cervix with lidocaine, although this area has no nerve endings. Local anesthesia is performed more to calm the patient than for any practical purpose.

Next, the procedure itself is carried out. To do this, they use a device that evaporates the liquid inside the cells, thereby coagulating them. After the operation is completed, a small wound is formed that heals quickly.

After the operation, it is recommended to refrain from sexual relations, douching, hypothermia, overheating and physical activity.

Many women worry whether the elasticity of the cervix will remain after treatment for cervical dysplasia. The injury during the operation is not deep at all, heals quickly and has nothing to do with the muscle layer of the cervix.

This is an important question, since there is an opinion (especially among older people) that after coagulation it will not be possible to give birth naturally. Or the birth will take place with complications and cervical rupture.

All these superstitions date back roughly to the Stone Age.

Conclusions:

1. Cervical cancer is the fourth most common cancer in women
2. Cervical cancer never occurs “suddenly” on its own. It is always preceded by dysplasia
3. Cervical dysplasia is curable, but the more severe the degree, the more difficult and more likely it is to develop into cancer.
4. Surgical treatment (cauterization) of cervical dysplasia is painless and gives good results. After this procedure, the cervix heals quickly and retains its elasticity.
5. Cervical dysplasia rarely manifests itself. Therefore, in order not to miss the moment, it is necessary to undergo regular examinations by a gynecologist. For women who have been diagnosed with oncogenic strains of HPV, the cervix should be examined once every six months.
6. If you have been diagnosed with “bad” strains of HPV, then there is no need to panic. Most often they leave without a trace. This is simply a reason to be more attentive to your health.

See a doctor on time - this is the best way to prevent serious diseases!

Read answers to popular questions about cervical dysplasia here

Source: https://medsimple.com.ua/displaziya-shejki-matki/