In the normal state, the cervix is covered with cells of the stratified squamous epithelium. It consists of three layers: basal, intermediate and superficial. Doctors may call any change in the maturation or differentiation of epithelial cells dysplasia. This term is often called all precancerous conditions of the cervix.
Possible diseases
Doctors distinguish several pathological conditions that must be paid attention to. So, in a separate group the so-called background processes are combined. These include true erosion, simple leukoplakia, polyps, ectopy, erythroplakia of the cervix. Separately, a precancerous condition called cervical intraepithelial neoplasia or dysplasia is isolated. It is important to understand that background and precarcinoma conditions have different pathogenesis.
But the origin and manifestation of precancerous conditions and cancer are similar. One of the reasons many call HPV. So, the presence of the human papillomavirus in the body is not a guarantee that there will certainly be cancer. But in those women who discovered precancerous conditions of the cervix, in 90% of cases they were still diagnosed with HPV. But it must be understood that of the more than 60 types of this virus, the genitals affect about 20, and 11 serotypes are considered highly oncogenous.
Papillomovirus
Most often, people do not suspect that they have HPV in their bodies. In some, the disease proceeds in a latent form. This means that people are carriers of the virus, but they do not have any manifestations. With a 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 papillomovirus serotype. Infection, as a rule, passes completely imperceptibly and is not accompanied by the appearance of any symptoms. But at the same time, the virus infects the cells, it is embedded in their genetic code, and the replication of infected elements begins. This ultimately leads to their degeneration and causes dysplasia or cancer.
But it is believed that the individual susceptibility of the epithelium and congenital defects of defense mechanisms play an important role in the development of diseases.
Characterization 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 adolescent girls, a gynecologist can see a displacement of the cylindrical epithelium upon examination. After colposcopy, it becomes clear that it is bright red. At the same time, it is impossible to color it with the Lugol solution. This condition is often called pseudo-erosion or ectopia. It can be congenital or acquired. But this is not a precancerous condition of the cervix, so such erosion does not require treatment. It is only necessary to observe them regularly.
If the patient's mucous membrane of the cervical canal is inverted to the vaginal area of the neck, then this condition is called ectropion. This is a combination of cicatricial deformation of the cervical tissue and pseudo-erosion. Upon examination, the doctor may see a deformed neck with a slit-like or gaping pharynx with red sections of the cylindrical epithelium. Often they can be with a transformation zone.
Another background process is leukoplakia, the name of the disease translates as "white spot". In this disease, a multilayered epithelium is keratinized locally. At the same time, infiltrates form around the stromal vessels. Leukoplakia can be simple, then it is referred to as background processes. If atypical cells appear with this disease , then we are already talking about precancer.
Erythroplakia is another disease, but it is quite rare. This name literally translates as "red spot". In this condition, the multilayer epithelium atrophies, it thins to several layers. Intermediate cells disappear. Blood vessels shine through the thinned epithelium, so the areas look like red spots.
Also, upon examination, the doctor can see outgrowths covered with epithelium. They are called polyps. These are bright pink formations, which can be leaf-shaped or oblong. They hang from the pharynx of the cervix.
Causes of erosion
Often problems can be detected by routine examination or colposcopy. If the doctor sees the changes, he can explain why erosion of the cervix appears. So, the most common causes are:
- Infectious diseases, among which the most common are chlamydia, trichomoniasis, gonorrhea, ureaplasmosis, genetic herpes, papillomovirus;
- inflammatory diseases of the female genital organs;
- mechanical damage to the mucosa;
- hormonal changes.
As a result of changes, the multilayer epithelium, the layers of which are poorly adhered and loosely laid, is damaged and peeled in places. It was noticed that this happens 5 times more often in women with menstrual irregularities, they may even have greater cervical erosion. Instead of a desquamated layer, a cylindrical epithelium is formed.
Provoking factors are malfunctions in the cycle, frequent change of partners, early onset of sexual activity and reduced immunity. Many of those who have found these problems are wondering if there are any restrictions if cervical erosion has been diagnosed. What can not be done with this disease? There are no strict restrictions. It is important to simply regularly see a gynecologist, undergo all the necessary examinations and not refuse the prescribed treatment.
Background Process Diagnostics
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, spotting or a bloodline may appear. In this case, you should see a doctor as soon as possible. He is able to assess the condition, determine if there is erosion of the cervix. The name of the disease in such a situation is more important for the doctor. It is from the identified problem that the further treatment tactics will depend.
On examination, pseudo-erosion looks like a red spot of irregular shape. It stands out against the background of a pale mucosa. During colposcopy, it becomes clear that the problem areas are covered with red papillae of a rounded or oblong shape, because of them the surface looks like velvet. Do not be afraid of colposcopy, it's just an examination with a special device that can increase the area by 30-40 times.
Diagnosis of a disease such as leukoplakia is also not difficult. In some patients, keratinized layers of cells are visible to the naked eye, they look like white plaques that rise on the ectocervix (part of the cervix that protrudes into the vagina). In others, they can only be detected by colposcopy. To clarify the diagnosis of tissue, the neck can be treated with iodine solution. Affected keratinized areas do not turn brown; they look like a surface covered with a whitish film. To determine the nature of leukoplakia (simple or with atypical cells), a biopsy is necessary.
Also, upon examination, the gynecologist can see cysts on the cervix. The reasons for their appearance are as follows:
- genital infections that provoke the development of inflammatory diseases;
- neck injury during childbirth, abortion, diagnostic curettage ;
- hormonal disorders.
Cysts look like bags that are filled with mucus. They appear from the nabot glands, which look like small white swelling. If there are malfunctions in their work, then the ducts are closed. In the case when only one sac is visible during examination, it is called an endometriotic cyst. But there are times when there are several. In such situations, the doctor says that these are nabotov cysts on the cervix. The causes of their occurrence are desirable to find out. After all, their appearance can be triggered by infections that need to be treated. As a rule, doctors recommend only one treatment method - cyst removal. This is done by puncturing the sac, removing viscous mucus and treating the site of its appearance.
Treatment tactics
In cases where the doctor finds problems with the cervix, he should talk about what needs to be done next. So, first of all, the specialist will conduct a colposcopy, take material for a cytological examination and, if necessary, suggest a biopsy. A full examination allows you to determine what causes cervical erosion. It is also important to make smears on the microflora, to identify whether there are any infectious diseases. It is mandatory to find out if the patient has HIV, syphilis or viral hepatitis. In addition, the gynecologist can give directions to conduct an examination for the presence of trichomonads, ureaplasma, HPV, chlamydia, mycoplasma, gardnerella.
After that, you can start treatment. Depending on the size, reasons for the appearance and other factors, the gynecologist will suggest cauterizing the cervix with current, making cryodestruction, laser coagulation, or using the radio wave method.
In some cases, simply observing erosion is sufficient. This tactic is chosen in those cases when it is found in young nulliparous girls. Most often, they cause hormonal changes.
Description of treatment methods
Cauterization is one of the most common methods. But at the same time, the procedure has a lot of side effects. As a result of cauterization, coarse scars may form, narrowing the pharynx of the neck channel. In addition, healing after the procedure takes a long time. But, despite all the shortcomings,
cauterization of cervical erosion is often used
. Reviews indicate that the procedure is unpleasant, but it can not be called too painful. Many women just talk about discomfort in the lower abdomen. In addition, there may be vaginal discharge after the procedure.
The doctor should also warn of a number of restrictions. There must be sexual rest for at least a month after the procedure. There are also restrictions on weight lifting - you can wear no more than 2 kg. The ban is imposed on visiting saunas, baths, taking baths, and engaging in intense physical activity.
Cryodestruction often leads to a shortening of the cervix. In addition, the neck pharynx may narrow as a result of the procedure. Cryodestruction cannot be called excessively painful; patients are more confused by the accompanying unpleasant odor.
Many people prefer to use more modern methods, for example, a radio wave method for treating cervical erosion. It is carried out by a special apparatus "Surgitron." The electrode located in it emits high-frequency waves, they form heat when they meet with tissues. In this case, the cells seem to evaporate.
Also considered highly effective laser treatment. Exposure to a beam of waves leads to the fact that pathologically altered cells are removed. At the same time, the surrounding tissues are slightly affected. This method is considered the least traumatic.
Dysplasia characteristic
Most often, precancerous conditions develop with traumatic lesions of the cervix. Particular attention must be paid to those with cervical erosion. Cancer against the background of it is unlikely to begin to develop, but the fields of dysplasia in some cases are detected just against the background of pseudo-erosion.
Specialists distinguish 3 stages of this disease. The first degree is called easy. With it, the 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 during cytology, while scraping should be taken deeply.
In the second degree - moderate dysplasia - changes can affect up to 2/3 of epithelial cells. There should not be atypical cells at this stage.
In severe dysplasia of the third degree, cell maturation and differentiation takes place only in the surface 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 pronounced signs, it does not have characteristic symptoms. On examination, the gynecologist can determine ectopia, leukoplakia, see papillomas. Sometimes with dysplasia it happens that the cervix is not changed.
You can establish a diagnosis with a cytological examination of a smear taken from the cervix. If in the process of research it was found that in the taken material there are cells with dicariosis (a change in the nuclei), then histology is necessary. It is made from materials taken during a biopsy.
Causes of dysplasia
In most cases, it is 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 sutures on the cervix, then there is a violation of the nutrition of her tissues. And this can be an impetus to the development of the disease.
Provoking factors also include:
- immune and hormonal disorders;
- the presence of erosive foci - the transition zone between the flat and cylindrical epithelium located on the outer part of the neck is dangerous;
- the presence in the body of a highly oncogenic type of HPV.
Risk factors are as follows:
- earlier the girl began sexual activity at a time when the epithelium is still not normally formed;
- prolonged use of intrauterine and hormonal contraceptives;
- multiple births;
- the presence of sexually transmitted infections;
- malnutrition deficient in vitamins C, A and beta-carotene.
It was also found that affects the appearance of these female diseases and men's hygiene. Smegma, which accumulates under the foreskin, can cause precancerous conditions of the cervix to begin to develop. This is due to the presence of carcinogenic substances in it , which during sexual intercourse fall on the cervix.
Possible ways to get rid of the problem
The tactics of treatment directly depends on what degree of dysplasia has been diagnosed. So, at the first stage, it is often recommended to simply observe the tissues in dynamics and conduct conservative treatment, which is aimed at eliminating the possible cause of the onset of the disease. As a rule, antiviral or antibacterial therapy is carried out, designed to eliminate the causative agents of infection. In the absence of positive dynamics, as well as in cases where dysplasia of the 2nd or 3rd degree was immediately dianostic, surgical treatment is recommended.
However, it can be carried out in the same way as cauterization of cervical erosion . Reviews indicate that this method gives very good results. Cryodestruction or laser treatment may also be used. In some cases, diathermoconization is used. This method consists in the fact that the changed tissue is excised in the form of a cone, the apex of which is directed towards 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 likelihood of a reverse development of the disease - this happens in about half the cases. But in 40% of women it will progress, in the rest it will be 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 rather gentle and highly effective radio wave method for treating cervical erosion, there are those who refuse the procedure.
Some are starting to look for alternative methods. The most popular are douching with diluted calendula infusion (1 tsp. Per ¼ cup of water), eucalyptus (1 tsp. Diluted in a glass of water), tampons with sea buckthorn oil or mummy.
But these are not all the options how treatment of the cervix can be carried out with folk remedies. Some healers recommend brewing for douching with St. John's wort at the rate of 1 tbsp. lin a half-liter jar of boiling water. The grass must be boiled for about 10 minutes and insisted for at least half an hour.
If you decide to refuse qualified help and will be treated with the indicated methods, then regularly go to the gynecologist in order to monitor the condition of the cervix. Only in this way will it be possible to see deterioration in time and try to correct the situation.