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Diseases of a neck of uterus and methods of their treatment
Diseases of a neck of uterus are widespread in the modern world among women. At the same time the tendency to decrease in their quantity is not observed. Generally such diseases are characteristic of the young women staying at reproductive age.
Features of diseases of a neck of uterus
Diseases of a neck of uterus can be subdivided into several different groups: precancerous, malignant, inflammatory and background diseases.
Background diseases to which the ectopia of a neck of uterus, a leukoplakia, an erosion, an inborn ectopia, polyps of a neck of uterus belong have a different pathogeny. The neck of uterus is covered by two different types of an epithelium. The vulval part of a neck is created by a flat multilayer epithelium, and in the cervical channel the single-layer cylindrical epithelium is covered. Between these layers the part of a neck which carries a navaniye a transformation zone is located. In it most often morbid conditions also develop.
The illness of a neck of uterus of this type can be shown not only at women at reproductive age as the considerable changes in a female organism happening both in teenage and in a climacteric, sometimes become an origin of pathologies.
Background diseases very seldom pass into a malignant form. But nevertheless continuous supervision of the doctor and treatment of such illnesses has to practice surely.
Precancerous diseases of a neck of uterus are pathological processes which can lead to development of a malignant illness eventually. All these diseases are considered as a certain degree of a dysplasia of a neck of uterus. Specific symptoms at such diseases are not shown: all symptoms cause the accompanying pathologies of a reproductive system.
Cancer diseases of a neck of uterus are diagnosed as an effect of change of an epithelium of a neck. The malignant disease is always preceded by precancerous diseases. Oncological pathology develops generally in a zone of transformation of an epithelium. Increase in quantity of cases of cancer of neck of uterus is directly connected with irregular preventive visit of the gynecologist.
Inflammatory diseases of a neck of uterus are certain kinds of sexually transmitted infections which are shown owing to infection with causative agents of such diseases.
Ectopia of a neck of uterus
At development of this illness in the woman the cylindrical epithelium moves to a vulval zone of a neck of uterus. Sometimes this illness is also called a pseudo-erosion. The acquired and inborn type of a disease is defined. Several times more often the ectopia of a neck of uterus comes to light at women with the broken monthly cycle.
Especially expressed ectopia symptoms at patients are not observed: in certain cases the quantity increases is more white, bloody allocations after the sexual act appear. In the course of survey the doctor defines existence of the bright red site having irregular shape. The doctor selects treatment in an individual order. If the uncomplicated psevdoeoroziya takes place, then the specialist can be limited to regular supervision and carrying out necessary researches.
Ectropion of a neck of uterus
In this state the woman owing to ruptures of muscle fibers has an ectropion of a mucous membrane of the cervical channel on a vulval zone of a neck of uterus. Most often such pathology is shown at women after the delivery, abortions, diagnostic procedures. In this case it is about a combination of hems and a pseudo-erosion. Women with this illness do not state complaints to the expressed illness symptoms. Treatment if necessary is made by a surgical method.
Leukoplakia of a neck of uterus
Emergence of local processes of keratinization of a multilayer epithelium is characteristic of this disease. They can have different degree of manifestation. Besides, the simple and proliferating leukoplakia differs. In the latter case also atypia of cells takes place. Such state already belongs to precancerous illnesses of a neck of uterus.
The leukoplakia develops at women as an effect of immune and endocrine factors, influences of infections, and also turns out to be consequence of injuries. Accurate symptoms at this pathology are not observed. In the course of diagnosis of a disease not only cytologic research, but also a biopsy with the subsequent histologic inspection is conducted.
Eritroplakiya of a neck of uterus
The local atrophy of a multilayer flat epithelium owing to which it becomes thinner is characteristic of this illness. At an eritroplakiya emergence of red spots on an ektotserviksa is observed. Till today there are no exact data on an etiology and pathogeny of this illness. The different techniques allowing to destroy the illness center are applied to treatment.
Polyps of a neck of uterus
Develop on mucous the cervical channel. These outgrowths covered by an epithelium subdivide on ferruterous and epidermizirovanny. They have bright pink color, leaflike or oblong shape. At diagnosis of this disease it is important to differentiate it with big polyps of an endometria. It is possible to diagnose polyps by means of ultrasonic research. Polyps delete, using a method which is selected individually.
Endometriosis of a neck of uterus
Endometriosis of a neck of uterus – an illness in which development fabric, is close to an endometria is located in a vulval zone of a neck of uterus whereas normal such fabric has to be located only in a cavity of the uterus. This form of endometriosis is diagnosed rather seldom. The injuries of a neck of uterus got in the course of childbirth, and also diagnostic and medical procedures, for example, at a biopsy become major factors which provoke this disease. The expressed symptoms at endometriosis are not observed, however sometimes this pathology is shown by bloody allocations after sexual contact, and also before periods and after it.
Diagnosis of an illness is carried out by means of a kolkospkopiya, if necessary also the biopsy of a neck of uterus is appointed. After establishment of the diagnosis sometimes doctors come to a conclusion that the patient cannot appoint treatment of endometriosis of a neck.
Cancer of a neck of uterus
Both the etiology, and a pathogeny of precancerous diseases and a cancer of a neck are identical. One of serious origins of such pathologies is the virus of papilloma of the person. Approximately in 90% of cases of a dysplasia of different degree and an oncological disease of a neck of uterus the patient in an organism has a virus of papilloma of the person. The precancerous state can pass into cancer for the period from two to ten years. Therefore it is very important to find a dysplasia at early stages and to provide adequate treatment.
At a dysplasia the woman does not note manifestation of the expressed symptomatology. Therefore diagnosis of an illness assumes carrying out histologic research for the purpose of obtaining exact information.
Tactics of a cancer therapy and precancerous states is defined with age, a disease stage. Approximately in half of cases at a slight dysplasia of a neck of uterus only regular supervision as the disease recovers independently is appointed. At a dysplasia the conization of a neck of uterus made with use of different techniques is often appointed. Treatment of an oncological disease is appointed taking into account all specific features of a course of an illness.
Diagnosis of diseases of a neck of uterus
The specialist can find some pathological phenomena in necks of uterus when carrying out simple gynecologic survey. However survey of the cervical channel in this case remains unavailable. Besides, a little expressed neck pathologies can also remain out of attention of the specialist.
Other techniques are applied to more exact establishment of the diagnosis. So-called test of Schiller is a process of coloring of a vulval portion of a neck of uterus the drugs containing iodine. If healthy zones become brown under the influence of iodine, then in places which remained uncolored, there are certain pathologies.
Kolkoskopiya necks of uterus allows to receive the image enlarged in several tens times by means of the special tool – a kolposkop. Sometimes when carrying out this research specialists apply additional tests.
The method of a mikrokolposkopiya gives the chance to receive the image which is enlarged in hundreds of times. Therefore, thus it is possible to estimate morphology of cells adequately.
In the course of diagnosis cytologic research of smears under a microscope is also widely applied. The cytology of a neck of uterus gives the chance to define, the risk of transition of a precancerous state to cancer is how high at this stage. However its low sensitivity is considered a lack of this method.
If the methods stated above do not allow to establish precisely the diagnosis, then the doctor makes the decision on carrying out a biopsy of a neck of uterus. Ultrasonic research can become also additional diagnostic method.
As diseases of a neck of uterus are treated
At treatment of different diseases of a neck of uterus both local, and general methods of treatment of illnesses are applied. It is important that procedures were carried out by the experienced doctors having sufficient knowledge for providing an individual approach to treatment. Before any kind of therapy it is necessary to conduct full examination and to establish the correct diagnosis.
At some diseases, in particular at a dysplasia of a neck of uterus, the woman appoint the general therapy. First of all, women are recommended to complete a course of administration of drugs which include vitamins A and E. Kstati, these vitamins are appointed also in the preventive purposes. Besides, polyvitaminic complex drugs have to contain B6, B12, C vitamins, beta carotene, folic acid.
At treatment of precancerous conditions of a neck of uterus it is important to provide reception of cellulose, enzymes, selenium, Omega-3 fatty acid. It is possible to fill shortage of these substances not only by treatment by medicamentous drugs, but also by means of correction of a food allowance. However similar methods of treatment cannot effectively influence a condition of women for whom the moderated or expressed dysplasia is diagnosed.
If at the woman the insignificant erosion is revealed, then use of chemical coagulation is possible. This process assumes processing by special means of the place of an erosion. It is necessary to carry out about five such procedures. However this method can not always become pledge of an absolute recovery of the woman.
Surgical methods of treatment are applied taking into account a number of features. They should be carried out in the first two weeks of a monthly cycle as process of healing of fabrics takes place more actively under the influence of estrogen. At surgical intervention local anesthesia is mainly used. However also general anesthesia is in certain cases applied. At desire of the patient according to the recommendation of the doctor it is possible to accept some time sedative drugs.
The method of diathermocoagulation assumes cauterization of a neck of uterus. It is applied now rather often as this operation is simple in performance. But at the same time there is also a lack of such treatment: in the course of carrying out procedure it is very difficult to determine the required depth of coagulation of fabrics. Also in the presence near the place of coagulation of circulatory or absorbent vessel owing to a necrosis over time on a neck of uterus formation of a hem is possible.
The cryolysis of a neck of uterus is carried out with use of liquid nitrogen. In this case regulation of depth of influence on fabrics is also made only approximately. After such procedure the woman has long allocations. It is important to consider all specific features of an organism of the patient before carrying out such procedure. In particular, the doctor has to be convinced of absence at the woman of a cold allergy.
Treatment allows to work with use of the laser in two directions. By means of the powerful laser evaporation is carried out, and low intensive radiation allows to carry out laser conization of a neck of uterus. Sometimes the burn of fabrics or their overheat becomes a side effect of such treatment. However treatment by means of the laser assumes a bleeding stop at once after procedure. At procedure only the short-term anesthesia is used. The method is rather painful.
The method of radio wave surgery is contactless. The affected area is influenced by a radio wave which promotes destruction and evaporation of a cell. This procedure is carried out quickly, besides it is painless. After such operation the hem in view of lack of injury of muscles is not shown, however allocations of sanious character nevertheless can appear. Fabrics after use of such method are completely recovered, at the same time the term of the postoperative period, in comparison with other methods, is reduced. This method of therapy of diseases of a neck of uterus is recommended to women who did not give birth earlier.
Knife conization was considered as earlier rather popular method of treatment of pathologies of a neck of uterus. But today such technique is applied only to treatment of women for whom the dysplasia of a cylindrical epithelium, pathological ectropion, big ruptures of a neck of uterus is diagnosed. At use of this method for patients bleeding owing to a severe injury is shown. Respectively, healing lasts long relatively.
The trachelectomy is carried out only in the operating room as this surgical intervention assumes cone-shaped excision of tissues of neck of uterus, Anesthesia at the same time can be as epidural, and the general. Such operation is practiced at initial stages of an oncological illness of a neck of uterus.
It is important to consider several important requirements at the choice of a method of treatment of diseases of a neck of uterus: it has to be the safest, not provoke complications in the future, provide treatment and recovery in the shortest terms.
Postoperative period
During the period after operational treatment at the patient certain unpleasant symptoms can be shown: the pain in the bottom of a stomach having the pulling character, allocations from a vagina which can stop 2-4 weeks later. To relieve pain, to the woman the anesthetizing medicamentous means are appointed. The patient is forbidden to lift weights for a month, to use tampons, to make syringings and to conduct sexual life.
Antibiotics after an operative measure are not appointed. During the developing of severe bleedings, pains, deterioration in the general state, temperature increase it is necessary to address the specialist at once.
After operation with time some complications can develop. Hems on tissue of a neck of uterus are sometimes formed owing to what there is its deformation. Menstrual function can be broken, develop infertility as an effect of a stenosis of the cervical channel and other changes. In the presence of inflammations of urinogenital bodies their aggravation is possible.
Owing to use of some methods of treatment of diseases of a neck of uterus for women emergence of premature births as there is an untimely disclosure of the neck of uterus which was earlier exposed to operation is possible. Also the rupture of fetal membranes is possible. Therefore for earlier not giving birth women it is necessary to choose methods of therapy of diseases of a neck of uterus especially carefully.
Section: Gynecology