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Dysplasia of a neck of uterus
September 10, 2012
The dysplasia of a neck of uterus is a form of a precancer of a uterus which meets now especially often. The dysplasia is meant as existence of changes of a mucous membrane of a neck of uterus, and also the vaginas having a various origin.
At development of a dysplasia disturbances in the structure of the cells of a blanket of a neck of uterus are shown. Depending on a stage of a dysplasia there are changes not only in blankets, but also in deeper. Sometimes the dysplasia is designated as an erosion of a neck of uterus, however most of specialists incline to thought that this term cannot open an essence of the happening process completely. At an erosion there is a damage of fabrics which has mechanical character, and the dysplasia of a neck of uterus means existence of damages of structure of the cells of fabrics. That is at a dysplasia not only the cells having atypia signs develop but also there is a pathological change of a fabric complex in general.
Reasons of display of a dysplasia of a neck of uterus
Approximately the dysplasia develops in 95% of cases in the place of transformation of a neck of uterus. In this zone transition of a cylindrical epithelium in flat is noted. Under the influence of mechanical or physical character in this place the dysplasia develops.
There are several factors which define development of this disease in the woman. In particular, the dysplasia of a neck of uterus develops against a vaginitis, a vaginosis, a colpitis. Besides, the reason of development of a dysplasia it becomes frequent an ectopia and an erosion of a neck of uterus, a vulva leukoplakia. The illness is also often diagnosed as a result of an immunodeficiency for patients with AIDS, diseases, sexually transmitted.
Very often the dysplasia of an epithelium arises against defeat of an epithelium mucous a virus of papilloma of the person. Under the influence of a virus there is a proliferation of cells of a basal and parabasal layer. The cells affected with a virus gradually grow and move to upper layers of an epithelium in which the virus breeds. As a result virus attack provokes developing of a dysplasia.
Specialists allocate also other factors influencing development of a dysplasia: the early beginning of sexual life, and also early childbirth (aged till 16 flyings); frequent sexual contacts with non-constant partners; neglect by contraception methods, in particular, use of a condom; numerous abortions or childbirth. Higher risk to ache with a dysplasia exists at women who smoke as under the influence of a tobacco smoke the hypoxia is shown. As a result, local immunity considerably worsens, and the risk of emergence of microtraumas of an epithelium considerably increases. The long period of use of the combined oral contraceptives can also provoke a dysplasia of a neck of uterus.
Also as the factors influencing emergence and development of a disease it should be noted deficit of some vitamins (And, With, β-carotene)))))))))), poor quality of life, existence of a certain genetic predisposition to a disease.
Display of hormonal dysfunctions of any etiology can become one more reason of development of this illness.
Types of a dysplasia of a neck of uterus
Establishing the diagnosis, specialists use classification of a dysplasia which defines extent of defeat of a multilayer flat epithelium of a neck of uterus.
If at the patient the dysplasia of a neck of uterus of 1 degree is defined, then in this case a third of thickness of an epithelium is struck. Therefore, this degree is considered easy. This stage of a dysplasia is sometimes combined with hypostasis and vacuolation of cells of a medine.
If at the patient from 1/3 to 2/3 thicknesses of an epithelium are struck, then in this case the dysplasia of a neck of uterus 2 degrees is diagnosed. It is about average extent of defeat. At the same time polarity of an arrangement of an epithelium is broken.
If at the patient defeat of all thickness of an epithelium is revealed, then the dysplasia of a neck of uterus 3 degrees which is heavy degree of a disease is defined. At the same time there is no division of a flat multilayer epithelium into layers, the expressed cellular and nuclear atipizm takes place.
Symptoms of a dysplasia of a neck of uterus
As a rule, the expressed clinical signs at development of a dysplasia of a neck of uterus are not shown. However at the heavy, started dysplasia degree the woman can feel periodic pain in the bottom of a stomach. Besides, there can sometimes be allocations of bloody character in small amounts.
Approximately at 10% of women the hidden disease is noted. But most often microbic infections join a dysplasia. In that case the patient already notes the signs characteristic of other diseases: noticeable changes in a consistence and nature of allocations, pain, burning, itch.
Diagnosis of a dysplasia of a neck of uterus
In view of lack of the expressed symptomatology in the course of diagnosis of a dysplasia of a neck of uterus use of the clinical, tool and laboratory methods of research allowing to estimate cellular structure of an epithelium of a neck of uterus is of particular importance. Expediency of use of a specific method in each individual case is defined by the attending physician.
In the course of inspection the following methods are applied: a biopsy of a neck of uterus, a simple and expanded kolposkopiya, an endocervical curettage (procedure consists in carrying out a scraping mucous the channel of a neck of uterus).
Besides tests with acetic acid, researches on existence of sexually transmitted infections, definition of the immune status are applied.
If in the course of a kolposkopiya epithelium sites on which probably the dysplasia develops are found, then the biopsy and the subsequent histologic research is made. This method allows to define severity of a disease precisely.
Treatment of a dysplasia of a neck of uterus
Sometimes treatment of a dysplasia of a neck of uterus does not practice at all. Need of use of specific methods of therapy is defined by the treating specialist, at the same time being guided by a number of factors. At not giving birth women of early age sometimes the illness passes independently provided that it is about a dysplasia of an easy or average form of weight. At the same time the following conditions have to be met: the age of the patient does not exceed 20 years, only dot defeats take place, pathological process did not affect the cervical channel, there are no viral infections in an organism. But even in the absence of treatment continuous supervision at the doctor and carrying out researches is in that case shown each several months.
At purpose of treatment of a dysplasia it is obligatory to involve two directions: removal of the site affected with a disease and the subsequent recovery treatment. It is important to consider disease degree, age of the woman, existence of childbirth in the anamnesis, other risk factors.
To choose the correct method of removal of an atypical site, the doctor has to consider surely all specific features of a state of health of the patient. The matter is that certain types of an operative measure can provoke development of serious complications in the future. It can be emergence of hems on a neck of uterus, infertility, disturbances of a monthly cycle, disturbance of a course of pregnancy.
The technique of chemical coagulation is used most often if the true erosion, and at the same time defeats rather superficial and uncomprehensive is diagnosed for the woman. Also methods with use of electricity are applied to procedure of cauterization. Such procedure is made quickly, however after it on a uterus there can be hems.
Are often used at treatment of a dysplasia also the methods of a cryolysis and cryoconization consisting in freezing of affected areas by use of liquid nitrogen. However in case of heavy degree of a dysplasia and manifestation of malignant process freezing is not applied. The impossibility to precisely regulate the freezing depth, and also too long manifestation of allocations after carrying out procedure is considered shortcomings of such technique.
Cauterization of fabrics is also made with use of the laser. Operations using the laser allow to influence sites which underwent defeat most precisely. But at the same time such intervention rather painful, besides several days later is possible developing of bleeding.
Excision by cold and knife conization is applied now infrequently as this method is fraught with emergence of a number of complications: high injury, severe bleeding. On condition of diagnosing of the first stage of cancer to the woman carrying out a trachelectomy is appointed.
It is important to consider some features of treatment of a dysplasia. It is desirable to make operation at the beginning of a menstrual cycle as at this particular time recovery of fabrics happens most actively. Generally when carrying out operation local anesthesia is used. The general anesthesia is applied only in some cases.
During the postoperative period of the woman note emergence of allocations approximately for a month. In the first weeks there is also pain in the bottom of a stomach. During recovery after a surgery the woman is forbidden to lift heavy loads, to use tampons, to carry out syringing, to lead sex life. Sedative medicamentous drugs can be also used at this time, but appoint them in an individual order.
Approximately in three months after an operative measure it is important to hand over a cytologic smear for the purpose of check of productivity of procedure. As a rule, recovery of an epithelium happens in 6-10 weeks. Within the first year after operation it is necessary to carry out an inspection of a condition of an epithelium not less once in three-four months.
As recovery treatment it is important to complete a course of administration of drugs, containing vitamins A, E, C, V6, V12, bioflavonoids, β-carotene, folic acid and other microelements. In the course of researches a feedforward between a lack of some vitamins B an organism of the woman and display of a dysplasia of a neck of uterus was noted. Complex polyvitaminic means are also applied to prevention of display of a dysplasia. Food of the patient has to include in the recovery period also those products which contain a maximum of the specified vitamins and elements. It is recommended to use also every day green tea which positively influences recovery of an epithelium.
At purpose of methods of treatment the doctor surely considers character of the diseases accompanying a dysplasia. Before treatment in the surgical way there is an obligatory sanitation for the purpose of elimination of an inflammation if that takes place.
Also some national methods applied to treatment of a dysplasia of a neck of uterus are recommended. The course of treatment with use of tampons with propolis and butter is effective. For their preparation it is necessary to kindle 200 g of butter and to add 10 g of previously crushed propolis. It is necessary to boil this mix on protyazhenii15 minutes on small fire. After that liquid is filtered through several layers of a gauze. The tampon becomes impregnated with this mix and is entered into a vagina approximately for half an hour. Ointment needs to be stored in the cold place, and procedures with tampons are carried out for a month.
Also for treatment of a dysplasia it is possible to prepare tampons with an aloe and honey. For this purpose equal parts of fresh juice of an aloe and honey mix up, the tampon which for the night is entered into a vagina becomes impregnated with mix. A course of treatment – two weeks.
For daily syringing which has to be carried out in the morning and in the evening use infusion of green tea and a calendula. That to prepare it, it is necessary to take on one tablespoon of flowers of a calendula and dry green tea, to fill in mix with boiled water and to insist several hours. Syringing is carried out for one month.
It is very important to remember that diseases of a neck of uterus which treatment is not carried out in time can pass into a malignant form over time always. Therefore it is necessary to pass routine inspections in time and to undertake all measures for treatment of an illness.
Today use of the correct approach to treatment of a disease provides treatment of a dysplasia and the prevention of its regeneration in a malignant form.
Prevention of a dysplasia of a neck of uterus
The dysplasia of a neck of uterus can be shown not only at those women who treat the risk groups described above. Women who already began sex life have to observe accurately terms of routine inspections at the gynecologist.
The correct approach to the organization of daily food has to become an obligatory measure of prevention for each woman: in particular, it is necessary to use constantly the dishes enriched with useful microelements.
Important measure of prevention is also full refusal of tobacco smoking which communication with development of a dysplasia is accurately proved by scientists. It is important to follow rules of sexual hygiene, to use barrier konratseptiva, to provide timely treatment of all diseases of urinogenital system.