Precancerous conditions of the cervix. Diseases of the cervix: causes, symptoms, diagnosis and treatment

In the normal state, the cervix is covered with cells of multilayered planar epithelium. It consists of three layers: basal, intermediate and superficial. Any change in the maturation or differentiation of epithelial cells can be called dysplasia by doctors. This term is often called all precancerous conditions of the cervix.

Possible diseases

Doctors distinguish several pathological conditions, which must be paid attention. So, the so-called background processes are united into a separate group. These include true erosion, simple leukoplakia, polyps, ectopia, erythroplasty of the cervix. Separately, a precancerous condition has been identified, which is called cervical intraepithelial neoplasia or dysplasia. It is important to understand that background and precancerary conditions have different pathogenesis.

But the origin and manifestation of precancerous conditions and cancer are similar. One of the reasons many call HPV. Thus, the presence of human papillomavirus in the body is not a guarantee that there will necessarily be cancer. But in those women who have found precancerous conditions of the cervix, 90% of the cases still diagnosed with HPV. But it should be understood that of the more than 60 types of the virus, the genital organs affect about 20, and 11 serotypes are considered highly coenotic.

Papillomovirus

Most often, people do not even suspect that there is HPV in their bodies. In some cases, the disease occurs in a latent form. This means that people are carriers of the virus, but they have no manifestations. In subclinical form, cytological changes are diagnosed. Clinically expressed HPV is determined when exophytic and endophytic condylomas are visible.

The most common are the 16th and 18th serotype of papillomavirus. Infection, as a rule, passes absolutely unnoticed and is not accompanied by the appearance of any symptoms. But while the virus infects cells, it is embedded in their genetic code, replication of infected elements begins. This eventually leads to their degeneration and causes the appearance of dysplasia or cancer.

But it is believed that the individual susceptibility of the epithelium and the birth defects of the defense mechanisms play an important role in the development of diseases.

Characteristics of background processes

Gynecologists can diagnose a number of diseases of the cervix, which are characterized by special changes. So, doctors distinguish true, congenital and false erosion.

Even in teenage girls, a gynecologist can see the displacement of the cylindrical epithelium when viewed. After the colposcopy, it becomes clear that it is bright red. At the same time, it is impossible to paint it with the help of the Lugol solution. This condition is often called pseudo-erosion or ectopia. It can be congenital or acquired. But these are not precancerous conditions of the cervix, so such erosions do not require treatment. It is only necessary to observe them regularly.

If a patient has a mucous membrane of the cervical canal turned into the vaginal part of the cervix, then this condition is called an ectropion. This combination of cicatricial deformation of the cervical tissue and pseudo-erosion. Upon examination, the doctor can see a deformed neck with a slit or gaping throat with red areas of the cylindrical epithelium. Often they can be with the transformation zone.

Another background process is leukoplakia, the name of the disease is translated as a "white spot". With this disease, the multilayered epithelium locally cools. In this case, infiltrates form around the vessels of the stroma. Leukoplakia can be simple, then it is referred to as background processes. If at this disease there are atypical cells, then it is already a matter of precancer.

Another disease is erythroplasty, but it is rare enough. This name is literally translated as a "red spot". In this condition, the multilayer epithelium is atrophied, it is thinned to several layers. Intermediate cells disappear. Through the thinned epithelium, the vessels are radiating, so the patches look like red spots.

Also, on examination, the doctor can see the outgrowths covered with epithelium. They are called polyps. These are bright pink formations that can be leaf-shaped or oblong in shape. They hang from the throat of the cervix.

The causes of the appearance of erosion

Often, problems can be detected by routine examination or colposcopy. If the doctor sees the changes, he can explain what causes erosion of the cervix. So, the most common reasons are:

- infectious diseases, among which the most common are chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, genetal herpes, papillomovirus;

- Inflammatory diseases of female genital organs;

- mechanical damage to the mucosa;

- hormonal changes.

As a result of the changes, the multilayered epithelium, the layers of which are poorly adhered and loosely laid, are damaged and slough in places. It was noticed that this happens 5 times more often in women with menstrual cycle disorders, they can even have a greater erosion of the cervix. Instead of a depleted layer, a cylindrical epithelium is formed.

Provocative factors are disruptions in the cycle, frequent partner changes, early onset of sexual activity and reduced immunity. Many of those who have discovered these problems are interested in whether there are any restrictions if the erosion of the cervix has been diagnosed. What can not be done with this disease? There are no hard restrictions. It is important to simply observe regularly at the gynecologist, undergo all necessary examinations and not to refuse the prescribed treatment.

Diagnostics of background processes

As a rule, women with an affected cervix do not complain about anything. There are no symptoms of erosion. True, some have whitish discharge, which does not cause any discomfort. After sexual intercourse, there may be spotting or a syphilis. In this case, you should see the doctor as soon as possible. He is able to assess the condition, determine whether there is erosion of the cervix. The name of the disease in this situation is more important for the doctor. The further tactics of treatment will depend on the revealed problem.

On examination, pseudo-erosion looks like a red spot of irregular shape. It stands out against the background of pale mucosa. When conducting colposcopy it becomes clear that the problem areas are covered with red papillae of round or oblong form, because of them the surface looks like velvet. Do not be afraid of colposcopy, it's just an examination using a special device that can increase the area 30-40 times.

Diagnosis of such a disease, as leukoplakia, also presents no difficulties. In some patients, the cornified layers of cells are visible to the naked eye, they look like white plaques that rise on the ectocervix (parts of the cervix that protrudes into the vagina). In others, they can be detected only during colposcopy. To clarify the diagnosis of the cervical neck can be treated with a solution of iodine. The affected keratinized areas are not colored brown, they look like a surface covered with whitish film. To determine the nature of leukoplakia (simple or with atypical cells), a biopsy should be performed.

Also, when examined, the gynecologist can see the cysts on the cervix. The reasons for their appearance are as follows:

- Sexual infections that provoke the development of inflammatory diseases;

- injury to the neck during labor, abortion, diagnostic curettage ;

- hormonal disorders.

Cysts look like pouches that are filled with mucus. They appear from the glandular glands, which look like small white swellings. If there are failures in their work, the ducts are closed. In the case when only one bag is visible during examination, it is called an endometriotic cyst. But there are cases when there are several. In such situations, the doctor says that these are ponate cysts on the cervix. The reasons for their occurrence are desirable to clarify. After all, their appearance can be provoked by infections that need to be treated. As a rule, doctors recommend only one method of treatment - removal of cysts. This is done by puncturing the bag, removing the viscous mucus and processing the place of its appearance.

Tactics of treatment

In those cases when the doctor discovers problems with the cervix, he should talk about what needs to be done next. So, first of all the specialist will conduct colposcopy, take material for cytological examination and, if necessary, will offer a biopsy. A thorough examination allows you to determine what causes erosion of the cervix. It is also important to make smears on the microflora, to determine whether there are infectious diseases. It is mandatory to find out whether the patient has HIV, syphilis or viral hepatitis. In addition, a gynecologist can give directions for conducting a survey for the presence of trichomonads, ureaplasmas, HPV, chlamydia, mycoplasma, gardnerella.

Then you can start treatment. Depending on the size, the reasons for the appearance and other factors, the gynecologist will propose to cauterize the cervix with an electric current, do cryodestruction, laser coagulation or use the radio wave method.

In some cases it is enough to observe erosion. This tactic is chosen in cases when it is found in young nulliparous girls. Most often, they cause hormonal changes.

Description of the methods of treatment

Cauterization is one of the most common methods. But this procedure has many side effects. As a result of cauterization, rough scars can form, narrowing of the cervical canal. In addition, the healing after the procedure is long enough. But, despite all the shortcomings, the cauterization of cervical erosion is often used . The testimonies indicate that the procedure is unpleasant, but it can not be called too painful. Many women just talk about the feeling of discomfort in the lower abdomen. In addition, after the procedure, there may be vaginal discharge.

The doctor should also warn about a number of restrictions. There must be sexual rest for at least a month after the procedure. Also there are restrictions on lifting weights - you can wear no more than 2 kg. The ban is imposed on visiting saunas, baths, taking baths, taking intensive physical activities.

Cryodestruction often leads to shortening of the cervix. In addition, the procedure may narrow the cervical sagging. Excessively painful to call cryodestruction is impossible, the patients are more confused by the accompanying unpleasant smell.

Many people prefer to use more modern methods, for example, a radio wave method for cervical erosion. It is conducted by the special apparatus "Surgitron". The electrode located in it emits high-frequency waves, they form heat when they meet the tissues. In this case, the cells seem to evaporate.

Laser treatment is also considered highly effective. Exposure to a wave beam results in the pathologically altered cells being removed. In this case, the surrounding tissue is slightly affected. This method is considered the least traumatic.

Characteristics of dysplasia

Most often, precancerous conditions develop with traumatic lesions of the cervix. Particular attention must be paid to those who have cervical erosion. Cancer against the background of it is unlikely to begin to develop, but the fields of dysplasia in a number of cases are found just against the background of pseudo-erosions.

Specialists distinguish 3 stages of this disease. The first degree is called light. Deep layers are affected - basal and parabasal epithelial cells. The upper layers remain normal. External signs of the disease are absent. It can be detected only when carrying out cytology, while scraping should be taken deeply.

At the second degree - moderate dysplasia - changes can affect up to 2/3 of epithelial cells. At this stage there should not be atypical cells.

In severe dysplasia of the third degree, the maturation and differentiation of cells passes only in the superficial layer. The remaining layers are affected. More detailed examinations show the presence of cells with atypia.

Diagnosing dysplasia is not so simple. The disease proceeds without any expressed signs, it does not have any characteristic symptoms. On examination, a gynecologist can determine ectopia, leukoplakia, and see papillomas. Sometimes with dysplasia it happens that the cervix is not changed.

To establish the diagnosis it is possible at cytologic research of a smear taken from a neck of a uterus. If during the research it was found that there are cells with dikariosis (a change in nuclei) in the material taken, histology should be performed. It is made from materials taken during a biopsy.

Causes of dysplasia

In most cases it can be difficult to understand what became the basis for the appearance of problems with the reproductive organs of women. But there are a number of factors that can trigger the onset of the disease. So, for example, if the patient has stitches on the cervix, then there is a disturbance in the nutrition of her tissues. And this can be an impetus to the development of the disease.

To provoking factors also carry:

- Immune and hormonal disorders;

- the presence of erosive foci - a transitional zone between the flat and cylindrical epithelium, located on the outer part of the cervix, is dangerous;

- the presence in the body of a highly-oncogenic type of HPV.

Risk factors are the following:

- Previously, the girl began to have sex at a time when the epithelium is not normally formed;

- long-term use of intrauterine and hormonal contraceptives;

- multiple births;

- the presence of infections that are sexually transmitted;

- malnutrition with a deficiency of vitamins C, A and beta-carotene.

It was also found that it affects the appearance of these women's diseases and men's hygiene. Smegma, which accumulates under the foreskin, can cause the precancerous conditions of the cervix to develop. This is due to the presence in it of carcinogenic substances that enter the cervix during sexual intercourse.

Possible ways to get rid of the problem

The tactics of treatment directly depends on what degree of dysplasia was diagnosed. So, at the first stage, it is often recommended to simply observe the tissues in the dynamics and conduct conservative treatment, which is aimed at eliminating the possible cause of the disease. As a rule, antiviral or antibacterial therapy is used to eliminate infectious agents. In the absence of positive dynamics, as well as in those cases when dysplasia of the second or third degree was immediately diagnosed, surgical treatment is recommended.

In this case, it can be carried out in the same way as cauterization of cervical erosion . Feedback indicates that this method gives very good results. Cryodestruction or laser treatment may also be used. In a number of cases, diathermoconization is used. This method consists in the fact that the altered tissues are excised in the form of a cone, the apex of which is directed toward the internal pharynx. The removed tissue sites are additionally sent for histology.

It is important to know that in patients with dysplasia the risk of developing cancer is 10-20 times higher than in those who do not have this problem. At the first stage there is a chance of reverse development of the disease - this occurs in about half the cases. But in 40% of women it will progress, the rest - in a state of stabilization.

Alternative Medicine

Hearing an unpleasant diagnosis, not everyone agrees to treatment with traditional methods. Even if the doctor offers a fairly gentle and highly effective radio wave method for cervical erosion, there are those who refuse the procedure.

Some start looking for alternative methods. The most popular are douches with diluted calendula infusion (1 tsp per ¼ glass of water), eucalyptus (1 tsp diluted in a glass of water), tampons with sea buckthorn oil or mummies.

But this is not all the options, how can treatment of the cervix with folk remedies be carried out. Some healers recommend brewing St. John's wort for syringing at the rate of 1 tbsp. L. For a half-liter can of boiling water. The grass should be boiled for about 10 minutes and insist for at least half an hour.

If you decide to give up skilled care and will be treated by these methods, then go to the gynecologist regularly to monitor the condition of the cervix. This is the only way to see the deterioration in time and try to remedy the situation.