Gynecology

How is the diagnosis of cervical dysplasia: methods of research and how to prepare for them

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Cervical dysplasia is one of the most common pathologies today. A biopsy of the cervix is ​​the main way to determine the nature of the disease and timely identify the risk of developing a malignant tumor.

Thanks to this research, it is possible to determine the rate of progression of changes in the tissues of the cervix. Based on the biopsy data, it becomes possible to determine the subsequent development of the disease.

Doctors talk about the high accuracy and reliability of this diagnostic method. With the results of a biopsy, it is much easier to make an optimal treatment regimen than in the absence of them. A biopsy of the cervix is ​​also performed for the purpose of prophylaxis for the early detection of changes in the cells forming the cervical tissue.

Survey methods

When conducting a biopsy, doctors are guided by the principle that most types of cervical pathologies are asymptomatic and are not determined by visual inspection. With timely treatment, the prognosis is always favorable.

Cervical dysplasia is considered a precancerous condition, therefore, special attention is paid to the diagnosis and treatment of cervical dysplasia. If a cervical epithelium is suspected, several methods of examination are used at once. These include colposcopy, curettage, smear microscopy and biopsy.

With an integrated approach to the study of the disease, doctors manage to figure out in which direction the disease is moving and how great is the threat of a malignant tumor.

In cervical dysplasia, structural changes occur in the tissues, and more specifically in the epithelial layer. Therefore, the main task of all these survey methods is to identify such violations in time.

Colposcopy

For example, colposcopy is an examination of the vagina and the vaginal part of the cervix using instruments. In this case, the woman does not feel pain. Under certain circumstances, physicians are required to examine hidden areas, in which case an extended colposcopy is performed.

This method of examination is always used at the slightest suspicion of the development of a cancer. In this diagnostic method, the intended lesion is treated with a weak solution of acetic acid. Further, the same area is smeared with Lugol solution. After this inspection is carried out using special equipment.

Scraping

The following examination involves curettage of affected tissues. This technique is effective in a situation where colposcopy does not allow to fully detect changes in the structure of cells due to their location. In this case, it is only possible to obtain material for research by performing scraping. The procedure is performed by a curette.

Those fabrics that were obtained during curettage are sent for examination to the laboratory. This survey method allows you to determine the degree of development of the process. But in the conditions of modern development of medicine, these types of examinations faded into the background and began to perform a secondary role. To date, they have become only additional criteria for assessing the state of the cervix.

A smear from the cervix may be taken for examination. In this case, cells for analysis are taken from places where, according to the doctor, there are already changes or may begin shortly.

When receiving material for research using colposcopy, a cotton swab is used. On it are cells that are subsequently transferred to a glass slide. When studying the structures of these cells, an irregular shape of their cell nucleus is found to turn out to be unequally distributed chromatin in the nucleus itself.

It becomes well noticeable difference between the size of the nucleus and the size of the cell. It turns out that the size of the nucleus is much larger than the size that should be in this significant part of the cell is normal. All of the above methods of examination are widely used not only to detect cervical dysplasia, but also for the diagnosis of associated diseases.

The most effective way to determine the various pathologies of the cervix today is biopsy of the cervix. In 90 percent of cases, a biopsy allows you to identify the incipient cell regeneration. How to take a biopsy of the cervix with dysplasia?

A biopsy can be taken by a doctor when she is examined in a chair. In some cases, when the area of ​​the modified tissue is too large, it is done in the hospital. An important condition is the rejection of drugs that lower blood clotting for several weeks before the examination. For twelve hours will have to give up drinking, eating and taking any medication. A layer of specially prepared, pre-treated with acetic acid is taken on the study.

Based on the results of the study, it is determined whether there is a threat of the growth of a malignant tumor. During the study of this material, the further course of the disease is predicted and treatment is determined. This diagnostic method allows you to immediately exclude the presence of other diseases of the cervix.

In dysplasia, biopsy as a diagnostic method is important because it allows one to determine not only the presence of pathology, but also the degree of its development, to determine the speed with which changes occur. Based on the data obtained, the tissues that underwent alteration are removed.

Biopsy technique

The material is collected using a colposcope. The obtained cellular material is tinted and only after that is studied under a microscope. Usually a hint of the presence of pathology is a well-marked broken layering. In healthy epithelium, layers can be easily traced.

In case of cervical dysplasia, this is problematic. In the affected tissues, the cell maturation process is disturbed. Contacts between cells are not so intense. Significantly changes the shape of cells. Cells of the squamous epithelium become round and cylindrical. All these changes helps to reveal the biopsy. And the most important thing is that a biopsy helps to assess the chances of cervical dysplasia passing into a cancer.

At the time of receipt of the material, the patient experiences minor pain. But the importance of the analysis is such that no one refuses it. Because detecting cancer at the initial stage is a great success, and it is all the more important to prevent it from occurring.

Complications after a biopsy is almost never the case. There are cases when a small bleeding started after taking the material, which appeared due to poor blood clotting. In the presence of infection in the vagina, antiviral drugs, as well as antibacterial drugs, are prescribed for the prevention of wound infection.

According to the doctors, all the consequences of taking a biopsy will disappear much faster if you are more careful with the body within four weeks. This means that it is necessary to avoid increased physical exertion, not to visit baths and saunas, not to use too hot water for hygienic procedures.

In the case of the onset of menstruation during the recovery period after a biopsy, the use of tampons is not recommended. It is forbidden to use any ointments, candles, except those that were prescribed by a gynecologist.

What is dysplasia

The mucous layer of the cervix consists of three layers, the formation of new cells occurs in the lowest (basal) layer. Young cells have a round shape and the only large nucleus.

As the cells mature and move into the intermediate layer, and then into the surface layer, they flatten and the size of the nucleus decreases.

When dysplasia disrupts the cell structure itself - it is much larger than normal, and in addition, it can have more than one nucleus.

The changed form and structure of cells leads to the fact that the differentiation into layers is lost, and atypia develops.

Depending on the depth of the spread of pathological cells, there are 3 degrees of the disease.:

  • Grade 1 - the lesion affects only the lower part of the mucosa,
  • 2 degree - atypical cells are found both in the basal and in the intermediate layer,
  • Grade 3 - pathology captures all three layers of the mucous membrane, but does not go beyond the limits of the organ, that is, a non-invasive oncological process develops.

Causes

Most frequent cause of dysplasia the presence of cervical papillomavirus is considered.

The greatest danger in this case are strains with a high oncological index - 16 and 18.

The longer the virus is on the mucous, the higher the likelihood of the development of atypical cellular structures.

The risk of developing dysplasia increases with the following provoking factors.:

  • low immunity
  • frequent changes of sexual partners, partner with oncology of the penis,
  • smoking,
  • abuse of oral contraceptives,
  • avitaminosis,
  • a large number of births
  • early childbirth
  • inflammatory and infectious processes in the genitals, which have a long course,
  • mechanical damage to the mucous membrane as a result of abortions, childbirth, surgical interventions,
  • hormonal imbalance,
  • genetic predisposition.

Symptoms of pathology

The clinical picture of unspecified dysplasia is usually not expressed.. Most often, women go to a specialist when viral, bacterial or fungal infections join the pathology.

In this case, the patient complains of an increase in the number of whiter, the appearance of discharge with an unpleasant smell, itching, burning, discomfort or pain during intimate intimacy, as well as the occurrence of bloody discharge after sexual contact..

If the disease is severe, pain may occur in the lower abdomen.

Therefore, doctors once again emphasize the importance of regular visits to the gynecologist for prophylactic purposes.

Diagnostic measures

If dysplasia is suspected, the specialist conducts various tests and uses a number of methods.:

  1. The very first examination is an examination of the patient in a gynecological chair.. The purpose of this survey is to detect changes in the mucous that are visible to the naked eye. The doctor can see spots, discoloration, the appearance of characteristic luster, notice that the integumentary epithelium has grown abnormally. As a rule, after an examination in a chair, the doctor establishes a preliminary diagnosis, which must be confirmed or refuted, and this requires more advanced diagnostic methods.
  2. Cytology smear. In the course of this study, it is possible to identify abnormalities in the development of cellular structures, as well as to determine the size of mucosal cells. A specialist can get ahead of whether there are precancerous or cancerous processes on the mucosa or not. The material for laboratory tests is taken with a disposable brush, which the doctor scrapes off particles of the surface layer. The procedure takes a few seconds, while the woman is absolutely not experiencing discomfort. The results of the analysis will be ready in a day.
  3. PCR analysis. This research helps to find pathogenic microorganisms that are difficult to identify with cytological analysis. In addition, atypical cells can be detected during this study. To obtain the necessary material, the doctor will need a smear for dysplasia or the patient’s morning urine. The study gives very accurate results that indicate not only the genus, but also the type of pathogenic flora.
  4. Hormonal homeostasis. Since dysplasia can be triggered by prolonged and uncontrolled intake of contraceptive oral agents, it is necessary to pass an analysis on the concentration of sex hormones. In addition, a urine test may be recommended, which will show how intensely hormones are excreted in the urine.
  5. Clinical analysis of urine and blood. In the blood, a specialist determines the level of hemoglobin, platelets, erythrocytes and leukocytes, and in the urine the presence of protein suspensions, nitrites and other microelements, the presence of bacteria, erythrocytes and epithelial cells is also detected.
  6. Biopsy - This is the most accurate diagnostic procedure that allows to identify the following points that are inherent in dysplasia: the absence of mucosal lamination, underdeveloped or atypical cellular structures, malfunctions in the synthesis of glycogen, a large number of ribosomes.
  7. Ultrasound - This is a hardware diagnostic that can be performed through the abdominal wall, transrectally or transvaginal way. The first two methods may be used for virgins and pregnant women, but transvaginal examination is considered more informative. What can be seen on ultrasound? The shape of the neck, its location, size and wall thickness.
  8. Colposcopy. This method is more informative than ultrasound. It is carried out with the help of special optical equipment, which increases the mucous membrane in a 30-fold volume. Before examining the mucosal surface, the doctor treats it with a solution of vinegar and lubricates with Lugol's solution.

Decryption of tests and the extent of the disease

The stages of pathology are abbreviated as CIN, which stands for cervical intraepithelial neoplasia.

Not so long ago, the terminology of the CIN was replaced by SIL, but many doctors still use the first option.

In grade 1 dysplasia, the papillomavirus penetrates into cellular structures and begins to accelerate their growth.. This can lead to the formation of condylomas on the mucosal surface.

With 2 and 3 degrees of pathology, cellular changes are not only neoplastic in nature, but also completely transformed, expanding the boundaries of the pathological process.

The number of altered cells dominates, which leads to the replacement of healthy layers not only of the cervical glands, but also of the canal itself.

Decryption of laboratory tests can take from a day to a week, and as for the hardware examination, after examination the doctor immediately deciphers and paints the results..

When turns into cancer

Stage 3 dysplasia is non-invasive cancer. This means that cancer processes have started, but they do not go beyond the neck.

In the absence of immediate and adequate treatment, atypical cells can begin to damage adjacent tissues, vessels, and nerves, leading to cancer.

How to take a biopsy of the cervix

The methods of cervical biopsy may be as follows:

  • simple puncture. The material can be taken at the usual polyclinic,
  • endocervical - get mucus from the cervical canal,
  • electrosurgical - biological material is obtained using radiobath,
  • conization - a wedge-shaped piece of tissue is excised with a laser or scalpel,
  • trepanobiopsy - material for analysis is taken from several sites at once.

The patient is located in the gynecological chair, the doctor cleans the mucous membrane and, if necessary, anesthetizes, then the biomaterial is collected using any of the methods listed above..

The whole procedure takes no more than 30 minutes, after which the woman can go home.

How to prepare for the collection of analyzes

In order for the analyzes to be as accurate as possible, the following preparation rules must be observed.:

  • two days before testing to refrain from sexual intercourse,
  • two days to stop taking antibacterial, antiviral and hormonal drugs,
  • do not use vaginal tablets, creams, suppositories, and so on,
  • on the day of the examination you can not douche
  • The last visit to the toilet should be 3 hours before the examination,
  • extreme food intake must be at least 10 hours prior to testing,
  • It is forbidden to smoke and take alcohol products.

Diagnosis of cervical dysplasia should be as early as possible.

More advanced and complicated forms are treated surgically, up to complete removal of the cervix.

Ultrasound: can you see cervical cancer

The question of whether cervical cancer is visible in a study such as an ultrasound is asked by the patient's oncologists. Whether it is possible to see a tumor on the cervix using ultrasound depends on its size. Despite the fact that the ultrasound method of the study is one of the most accurate procedures, it is impossible to make a final diagnosis without additional tests.

Ultrasound examination allows to obtain an accurate description of all changes occurring in the cervix. With the help of ultrasound, you can identify the slightest changes, but deciphering these changes have to deal with a doctor. Cancer of the cervix on the ultrasound to determine with an accuracy of 100% is impossible, so if you detect suspicious tumors, you will need to undergo additional research. With the help of such a diagnostic method as ultrasound, one can identify:

  • condition of the uterus,
  • determine the roughness of the contours
  • type of education growth,
  • the degree of germination of the tumor
  • the degree of lymph node change,
  • spreading the cancer process to other organs like the bladder and intestines,
  • the presence of metastasis.

Рак шейки матки на ранних стадиях не имеет симптомов проявления, поэтому основным способом его выявления являются различные методики. С течением времени, рост опухоли приводит к тому, что возникают бессимптомные кровотечения, нарушение менструального цикла, а также возникновение белей.

It is important to know! With the help of ultrasound, you can identify inflammatory processes that occur in the reproductive organs of women. This type of research is widely popular among women, as it is possible to determine various pathologies and abnormalities in a timely manner.

Features of the ultrasound

To determine cervical cancer on ultrasound, you must first resort to preparatory procedures. Such procedures include:

  1. Conducting a cleansing bowel enema through the rectum. This method of cleaning the intestines is carried out no later than 6 hours before the ultrasound examination.
  2. It is also important before the passage of the ultrasound that the woman kept for a while protein-free diet. One hour before the examination, you need to drink a certain amount of fluid, which will provide more detailed information about the condition of the organ.
  3. After that, a special ultrasound sensor is inserted into the vagina or driven by a conventional device in the lower abdomen. The sensor is pre-lubricated with petroleum jelly or special fluid.

During the study, the specialist determines all the important points. Any defects in the cervix may cause a tumor.

When the doctor prescribes an ultrasound examination

Before conducting a diagnostic study, the doctor conducts a survey of the patient, and also collects anamnesis. For an ultrasound procedure, the following indications should be given:

  • Weakness of the body, as well as fatigue after rest.
  • Anemia.
  • The body temperature, which is kept for a long time at a low-grade level.
  • Soreness of the pelvic region, as well as adjacent organs.
  • Diseases of the genitourinary system.
  • Intestinal disorders, manifested as constipation or diarrhea.

If the symptoms listed above are present, the doctor will necessarily refer the patient to an ultrasound test, which will allow for the timely detection of signs of oncology.

Ultrasound Techniques

To determine the signs of cervical cancer, an ultrasound scan can be used using one of two methods:

  1. Transabdominal. The examination involves filling the bladder, which is possible due to the patient's use of a certain amount of water (about 1 liter). Filling the bladder allows for a thorough examination of the cervix. A special gel is applied to the woman’s abdomen, by means of which the device’s permeability through the body is increased. Through the device, which is found in the stomach of a woman, the display of indicators on a computer monitor is carried out. A specialist at the same time leads his hand over the stomach sensor, and determines the state of the organ. A nurse records information that a specialist tells her.
  2. Transvaginal. This method does not require bladder filling, but it uses a special vaginal sensor. This sensor is inserted into the vagina, after which information is displayed on the monitor screen. This method is highly efficient, as it has more advantages in identifying tumor cells. Recently, often resorted to using transvaginal research to detect cancer.

It is important to know! Despite the effectiveness of ultrasound procedures, it is not recommended to resort to this method in the early stages of pathology. The procedure does not help to detect pathology, so it is better to use a method such as colposcopy.

How to detect cervical cancer on ultrasound

The main symptoms of cancer do not appear immediately, but only after the appearance of tumors on the organ, the size of which reaches 3 mm or more. It takes several years for the tumor to grow to such size. If during this period the woman does not visit the gynecologist, then the probability of detecting a tumor in the later stages is quite high.

On the basis of ultrasound, it is possible to determine the cervical cancer, as well as the following neoplasms:

  • the roughness of the contours
  • changes in the lymph nodes
  • vascular disorders
  • cancer of other organs,
  • the occurrence of metastases,
  • dysplasia.

For the detection of a tumor, only modern ultrasound equipment will be required. It can be used to determine tumors, the dimensions of which range from 3 mm. Usually ultrasound is carried out in a complex, which allows to determine not only the structure and thickness of the walls of the cervix, but also to examine all the organs of the small pelvis.

It is important to know! Ultrasound does not reveal erosion of the cervix, and it is this pathology at the advanced stage that leads to the formation of malignant tumors. To identify endometriosis, you must regularly visit a gynecologist.

If we compare ultrasound and other diagnostic methods, the first option has no contraindications to conduct, compared with the others. At the initial stage of the onset of a tumor, it is very difficult to determine the nature of the pathology. A tumor can be benign or malignant, so a biopsy will be required to clarify. Very often, experts are faced with the fact that uterine fibroids can develop into carcinoma, so even in cases with benign tumors, you need to make drastic decisions.

Complex methods for the determination of cervical cancer

To determine the pathology of the cervix, there are several effective ways. Despite the effectiveness of ultrasound, the ability to detect pathology also depends on such factors as the quality of the device, as well as the experience of the diagnostician. If there is the slightest suspicion of cervical cancer, and the ultrasound diagnostics gave negative results, then additional examinations should be performed.

To obtain one hundred percent result of the study for cervical cancer, you need to undergo a comprehensive examination:

  1. The screening procedure. The advantage of the method is the possibility of detecting pathology in the early stages, as well as the possibility of distinguishing the disease from precancerous pathologies.
  2. Colposcopy. Allows you to define erosion and pseudo-erosion, as well as start timely treatment.
  3. Biopsy and ultrasound. The essence of the method of ultrasound is understandable, and biopsy is a procedure for taking tumor tissue for further detailed study.

In addition, the main signs of manifestations of cervical cancer are the lack of clear contours of the cervical canal, impaired echogenicity values, changes in the structure of the uterus, the presence of fluid in the uterus, the appearance of heterogeneous structures in the uterus.

Summing up, it should be noted that absolutely anyone can become ill with cancer, and even one who leads an active lifestyle. Often, the main cause of cancer is the negative emotions that every person is exposed to. The less negative emotions a person has, the stronger the immunity. Even if a patient has been diagnosed with cancer, you should not lose heart, and immediately resort to alternative methods of dealing with it.

Who is shown to hold DEK

Currently 2 types of diathermosurgical treatment methods are used:

  1. Diathermocoagulation (DEK) - coagulation (cauterization) of the pathological foci of the cervix with an electric current.
  2. Diatermoexcision (DEE) - excision of the affected areas of the cervix, which are sent for histological examination.

DEC is a more gentle method of exposure. It is used in cases of mild cervical pathology and in situations where there is no need to confirm the histological structure of the affected area. Indications for cervical diathermocoagulation can be:

  • Uncomplicated ectopia. With extensive erosion, the presence of deformity and rupture of the cervix using diathermoexcision.
  • Mild dysplasia (CIN I, d degree dysplasia). With CIN ll the use of DEE is desirable.
  • Endometriosis. In case of extensive lesions (multiple or large single endometrioid cervical cysts), DEE can be performed.
  • Genital warts of the cervix and vagina. In case of flat warts, it is better to use DEE with histological verification of remote areas.

In what cases it is impossible

Before conducting diathermocoagulation, the doctor must ensure that there are no contraindications for this woman. This method cannot be used in the following situations:

  • In inflammatory processes of the female genital organs (colpitis, cervicitis, acute salpingoophoritis and endometritis). Before the procedure, the infectious pathology should be treated and control tests for its presence should be completed.
  • With cervical cancer. The application of this method in this case may cause the progression of the process and a significant deterioration of the condition.
  • During pregnancy. This is fraught with abortion.
  • In the early postpartum period.

How is the

Diatermocoagulation of the cervix is ​​performed on an outpatient basis, often under local anesthesia or without anesthesia.

Cauterization of tissues is carried out using a special probe - electrode. The second, passive electrode is placed under the patient’s sacrum.

Burning can be a bit painful. The duration of the procedure is up to 30 minutes. After her, the woman goes home.

What not to do after DEC

During the month after the intervention, the patient is recommended to have sexual rest, it is forbidden to lift weights, visit pools, baths, swim in open water, take hot baths, use vaginal tampons.

Normally, the rejection of the formed scab (crust) occurs 7–12 days after the procedure. At the same time small bloody allocations are possible. The final healing takes place in two months.

Types of cauterization of the cervix shock

Cauterization of the cervix with a current is one of the oldest and most common methods of treating cervix pathologies.

There are 2 types of manipulations of this kind:

  • DEK, or diathermoelectrocoagulation,
  • DEE, or diathermoelectroexcision.

The terms DEK and DEE designate destructive methods of treating the affected areas of the cervix with electric current.

In turn, DEC happens:

  • Monoactive (using one active electrode),
  • Biaktivny (using two active electrodes combined into one),
  • Inactive using an electrolyte solution.

During the procedure, an electrode is used that not only removes the affected tissues, but also makes it possible to coagulate the bleeding vessels, which makes the operation anemic and with small blood loss.

After surgery, the material is sent for histological examination to determine the cellular composition and the detection of atypical cells. Based on histopathological analysis, further tactics of management and treatment of the patient are developed.

Histological examination of material obtained during DEC (biopsy) helps to detect the presence of atypical cells.

Cauterization of the cervix with a current is used only in women who have given birth due to the high risk of the development of postoperative complications in the form of scar formation. It is not recommended to carry out this procedure in patients who are planning a future pregnancy.

The main difference between electrocoagulation and electro excision is the depth of excision of damaged tissues. When DEE captured the deeper layers of the epithelium, so this procedure is used for severe lesions of the cervix.

Diathermoelectrocoagulation allows to achieve the effect of complete healing of pathologically changed tissues in 70-90% of cases.

DEC is subdivided into superficial and deep.

Deep DEC happens:

  • With layered exposure,
  • With diathermopuncture.

In DEK, the doctor coagulates the entire surface of the cervix, as well as the mucous membrane of the lower third of the cervical canal.

Indications for coagulation are:

  • Pathology of the cervix on the background of cervical deformity,
  • Mild dysplasia.

Diatermoelectroexcision is a cervix conization using electric current. Conization is the excision of damaged tissues of an organ in the form of a cone, the top of which goes to the inner throat. In addition to DEE, other methods of this surgical intervention are used - with a scalpel, laser, radio wave equipment. The difference between these manipulations lies in the amount of procedures performed and the tools used.

During DEE, the pathological portion of the cervix is ​​excised conically.

DEA is assigned when:

  • Background cervical diseases that are accompanied by hypertrophy or cicatricial deformity of the cervix,
  • Mild dysplasia.

The conization of cervix is ​​a radical method of therapy that allows you to get rid of background processes. It is used when there is a risk of malignancy (malignancy), in the case of persistent relapse of the pathology and in other situations when other means have not brought the desired effect.

What do before cauterization of the cervix?

A woman must undergo a series of examinations before the cautery procedure.

Usually in this case, the doctor prescribes such studies:

  • Vaginal smear on flora,
  • Smear on oncocytology,
  • Determination of blood type and rhesus factor
  • General blood analysis,
  • General urine analysis,
  • Blood chemistry,
  • Coagulogram
  • Blood test for syphilis, hepatitis and HIV,
  • Ultrasound of the pelvic organs (if indicated),
  • Fluorography,
  • ECG,
  • Examination by a therapist
  • Simple and extended colposcopy
  • STI screening,
  • Biopsy of the cervix (if indicated).

Shelf life tests - 10 days.

A woman who is preparing to cauterize the cervix is ​​recommended to undergo a vaginal debridement.

If the test results are normal, the woman will be cauterized. In the presence of an inflammatory or infectious process, an appropriate therapy is first carried out with the subsequent re-delivery of tests.

With cervical erosion, cauterization is performed on the 5–7th day of the menstrual cycle, which allows for maximum healing by the time of the beginning of the next menstrual period. In certain cases, cauterization with current is carried out on the 9-10th day of the cycle (with prolonged menstruation).

It is also useful to read: Cryotherapy for pathology of the cervix (including erosion)

How is the procedure?

The essence of the procedure of cauterization of the cervix with a current is the use of a special electrode through which electric current is passed. In the absence of complications, the procedure of electrocoagulation lasts up to 30 minutes. The electrode is applied dotted to the affected surface of the cervix prior to the formation of a scab.

During the healing process, the scab is rejected and the wound is exposed. A scab begins to move away 10–12 days after surgery. Due to the lack of complete vascular coagulation during the rehabilitation period, a woman may have spotting bleeding from the genital tract. In the case when the scab is rejected at one time over a large part of the cervix, a complication may develop in the form of bleeding.

During electrocoagulation, a scab forms at the site of exposure and performs a protective function.

Prices for electrocoagulation of the cervix depend on the region of residence. The cost of the procedure in Moscow is on average 5,000 rubles.

“After cauterization of cervical erosion, which had been with me for 15 years, I completely forgot about the problem. Very afraid that it would hurt. It turned out 20 minutes of discomfort - and I went home. The doctor's recommendations were partially observed, but this did not affect the result. I was very pleased. ”

Recovery period after intervention

The restoration of the integrity of the cervix of the uterus is called the process of epithelialization, the term of which depends on the cautery method.

Healing after electrocoagulation occurs 4-6 weeks after the rejection of necrotic tissue. Epithelization occurs in 2–3 months. In some cases, the complete healing of cervix takes a longer period.

Epithelization after DEI occurs within 2–3 months.

The recovery period takes an average of 6 weeks with no complications.

At the site of the adherent tissue, a connective tissue scar is formed, which can cause prolonged labor or other complications during the labor process. It is recommended that cauterization of the cervix be given to women who have given birth, who do not plan to re-pregnancy in the near future.

After cauterization of the cervix, the woman becomes a dispensary account, the term of which depends on the pathology:

  • Cervical erosion - 3 months
  • I degree dysplasia - 2 years.

Control examinations and colposcopy after cauterization are carried out 3 months after the procedure. Clinical supervision is carried out by a doctor every 3-6 months.

What are the discharge after therapy?

The nature of discharge from the genital tract after cauterization of the cervix with electric current depends on the healing rate and the stage of the recovery process.

Normally, alterations vary as follows:

  • Bloody,
  • Slimy-bloody,
  • Pinkish or beige thick,
  • Brown scanty
  • Blood clots at any stage.

The figure shows the discharge after the DEC procedure is normal.

The stages of recovery of the selection can be:

  • Bloody smear. Immediately after surgery as a result of incomplete coagulation of the cervical vessels,
  • Mucous and bloody. In terms of take up to 10 days. The color of the discharge depends on the amount of blood impurity. Occur as a result of rejection of the scab,
  • Pinkish По времени занимают до 7 дней,
  • Слизистыми. После полного отхождения струпа,
  • Bloody in the form of gentle bleeding from the genital tract. May occur when the scab is completely rejected. By the time they appear from the 8th to the 21st day from the moment of surgical intervention. They take place in a few hours, after which they completely stop.

It is necessary to seek medical assistance during the recovery period if:

  • Heavy bleeding,
  • Increased body temperature
  • Abdominal pains,
  • Changing the smell of discharge.

If the patient doubts the amount of discharge, it must be remembered that they should not exceed the volume of menstruation. With a larger volume, specialist consultation is required.

The unpleasant smell of discharge after cautery may indicate the accession of the infection, which requires adjustment of treatment.

Contraindications to electrocoagulation

There are a number of contraindications for electrosurgical treatment of cervix, among which the most important are:

  • Inflammatory diseases of the urinary organs,
  • The presence of STIs,
  • Bleeding from the genital tract, including menstruation,
  • Impaired blood clotting in the stage of decompensation or in the absence of necessary therapy,
  • Cervical malignancy,
  • Gestation period (pregnancy)
  • Postpartum period up to 8 weeks
  • Diabetes in the stage of decompensation,
  • The presence of IUD in the uterus,
  • Patient's mental illness
  • Somatic chronic diseases in the acute stage.

It is also useful to read: Treatment of cervical erosion by radio waves

A relative contraindication for the procedure is the lack of a woman's childbirth and pregnancy planning.

Considering that scarring of the cervix is ​​one of the main complications after burning with a current, the procedure should be abandoned in favor of more benign methods if you are planning a pregnancy.

What are the consequences after DEC?

Consequences after burning cervix with current are divided into:

Among the early complications that arise in the first weeks after the procedure, there are:

  • Bleeding,
  • Exacerbation of chronic gynecological diseases,
  • Violation of the menstrual cycle in the form of delayed menstruation or amenorrhea.

Among the late complications emit:

  • Scar formation with the development of cervical canal stenosis,
  • Cicatricial changes in the underlying layer, or SKShM (coagulated cervix syndrome),
  • Repeated erosion
  • Endometriosis, the development of which is associated with delayed epithelialization of the cervix. If the healing process does not occur by the time of the next menstruation, the cells of the rejected endometrium can invade the cervix and form foci of inflammation,
  • Cystic degeneration of cervix,
  • Metaplasia.

In some cases, diathermocoagulation may cause the development of endometriosis when endometrial cells expand outside the uterus.

“When I was 18 years old, I was burned by erosion of the cervix with a shock. Impressions were terrible. It was very painful and smelled of fried meat. But the main thing: on the neck there are scars that can interfere with natural childbirth. Besides, I did not give birth. From my experience I do not advise anyone to cauterize the neck. And if you decide, read the literature and consult with different doctors. "

Pregnancy and childbirth

Planning of pregnancy after cauterization of the cervix with a current is possible no earlier than 3 months after the procedure. This time is necessary for the healing of the wound surface and the evaluation of the effectiveness of the treatment.

If there is evidence during pregnancy, additional colposcopic examination is possible.

Tactics of conducting childbirth after electrocoagulation depends on the age of cautery and the state of the neck.

During the passage of the child through the birth canal of the mother increases the risk of rupture of the cervix due to the presence of a scar at the site of cauterization. To reduce the risk of ruptures, full opening of the cervix and the absence of forced labor are necessary.

What to do after electrocoagulation? Recommendations of specialists

In order for the rehabilitation period after the electrosurgical intervention on the cervix to be effective, you need to follow the recommendations of specialists.

The recommendations are aimed at reducing the risk of complications and are as follows:

  • After removing erosion, it is impossible to lift weights and engage in heavy physical exertion for 6 weeks. If necessary, the woman is issued a certificate of light labor,
  • Prohibited sex 6-8 weeks after the procedure. Getting it is possible after an examination by a doctor
  • You can not swim in the open pond, visit the bath, sauna and take hot baths. It can cause bleeding,
  • It is necessary to observe personal hygiene: take a cool shower, make daily washing of the genitals,
  • To change the gaskets at least once every 3 hours, as pollution is more often,
  • Do not use tampons,
  • Do not produce transvaginal ultrasound,
  • Use topical treatment as recommended by a doctor, for example, swabs with levomecol or sea buckthorn oil to soften the eschar and prevent the addition of infection,
  • Do not plan a pregnancy earlier than 3 months after cauterization.

After the procedure, it is necessary to eliminate heavy physical exertion for the speedy healing of the wound surface.

Why are the reviews on burning of the cervix with current?

Reviews of cauterization of the cervix with current are both positive and negative. Even the doctors did not come to a unanimous opinion.

Among the positive moments it is necessary to note the following:

Of the negative points should be highlighted:

  • High risk of complications such as bleeding, scarring,
  • Restriction in use among birthless and planning pregnancy.

In general, the procedure of cauterization of the cervix by electric current is a possible alternative to other methods of treatment.

There is no consensus on how to treat the cervix. In order to recover, it is necessary to undergo a full examination and choose a method of therapy, which is individual for each patient.

Primary medical consultation

1200 rub. Making an appointment The cost of cervical diatermoelectrocoagulation is determined by the results of the initial consultation and analyzes

Consult with a specialist to find out if this treatment is suitable for you.

Diatermoelectrocoagulation is a method of treating diseases of the cervix uteri, which has been widely used for almost a century. The technique is based on the application of high-frequency current, which destroys the affected tissue without causing harm to healthy tissues.

Are there any complications?

The main disadvantage of this method is that it is quite difficult for a doctor to control the destruction of the deep layers of the cervix. The procedure often leads to the fact that the patient begins to bleed, and they can take place, both during cauterization, and after some time. In addition, there is a risk of recurrence, inflammation, menstrual disorders. In some cases, a narrowing of the cervical canal was observed.

What is erosion?

Erosion can be congenital, true and false (ectopia, pseudo-erosion).

Congenital erosion in most cases is not treated, since it tends to pass on its own.

Acquired erosion cannot be cured on its own, therefore it is recommended to treat them.

In fact, true erosion is a wound that forms on the mucous for various reasons. It can be mechanical damage, hormonal disorders, in addition, erosion can occur as a result of inflammatory processes in the genitals or due to sexually transmitted infections.

This form of erosion does not exist for long, and after two weeks goes into the next form - ectopia.

It is the ectopia that gynecologists diagnose in every second woman. In this case, on the mucous neck there is a complete or partial replacement of the squamous epithelium on the cylindrical.

This form of pathology may asymptomatically exist for several months and even years. In some cases, the woman may be disturbed by painful sensations during intimacy, the presence of uncharacteristic discharges, but more often the woman realizes that something is wrong after inflammation occurs.

A wound on a mucous membrane is a gate for infectious agents that penetrate inside and can lead to diseases accompanied by a vivid clinical picture.

Cautery methods

Today, there are several fundamentally different methods of cauterization, which doctors use to remove erosive areas on the cervical mucosa:

  • laser burn,
  • radio wave removal,
  • cryodestruction,
  • chemical exposure
  • vaporization by electric current,
  • argon plasma ablation
  • use of ultrasound,
  • electroconization.

PAY ATTENTION! Each of these methods has pros and cons, indications and contraindications, therefore, it is better to entrust the choice of method to a competent specialist.

Advantages and disadvantages

The undeniable advantages of this treatment:

  • outpatient care
  • the technical complexity of the manipulations is not high,
  • runs in a short amount of time
  • painlessness
  • the ability to use the laser only on the affected area, leaving healthy tissue intact,
  • the implementation of instantaneous coagulation of blood vessels, due to which there is no risk of bleeding,
  • low risk of developing inflammation or infection,
  • the duration of the recovery period is not more than 2 months,
  • high efficiency,
  • minimum of complications
  • no effect on the subsequent conception, childbirth and childbirth.

The disadvantages of laser therapy are the following:

  • not in all cases it is possible to cover the entire depth of the affected tissues,
  • in case of large erosion, several similar procedures may be required,
  • despite the fact that the development of bleeding is extremely rare, in cases of deep exposure, it is still possible,
  • high cost of the procedure.

Indications for

Indications for laser therapy are:

  • progressive and large erosive lesions,
  • severe symptoms of the disease - bleeding or soreness,
  • lack of contraindications and related backgrounds of ailments.

This method of erosion treatment has not been used by doctors for the first ten years, therefore the following contraindications have been identified:

  • pregnancy at any time,
  • viral diseases of the genital organs, in particular papillomavirus,
  • infectious and inflammatory processes in the reproductive sphere,
  • venereal diseases,
  • oncological processes in general and in particular in the pelvic organs,
  • problems with blood clotting and other pathologies in the blood system.

Tests for cervical dysplasia

The gold, common standard for diagnosing cervical dysplasia (CIN) is the PAP test. The analysis, named in honor of the doctor who first applied it. Cytological analysis is accepted as mandatory in all developed countries of the world. Its reliability is extremely high (up to 80%), especially if cervical dysplasia at the initial examination is defined as a first-degree disease.

In cytological material, the Pap test shows intraepithelial changes in the layers lining the cervix. Deviations from the norm are usually denoted in Latin letters, let's take a closer look at how it stands for:

  • SIL (Squamous Intraepitelial Lesions) or squamous intraepithelial changes.
  • LSIL (Low-Grade Squamous Intraepitelial Lesions) - epithelial lesions are not pronounced, low degree.
  • HSIL (High-Grade Squamous Intraepitelial Lesions) changes, atypia of epithelial cells are pronounced. Here there is a differentiation of analysis - a moderate degree of CIN II, carcinoma in the initial stage, less commonly diagnosed with CIN III.
  • AGUS - lesion of the glandular cell layer, cervical adenocarcinoma.

Analyzes, procedures that are suggested if cervical dysplasia is detected:

  1. Examination (bimanual examination in the gynecologist's office).
  2. Cytology.
  3. PCR.
  4. Inspection using a colposcope.
  5. Histology (cervical tissue biopsy).
  6. Conization (cone biopsy).

Cytology with cervical dysplasia is mandatory. This is a standard test that determines and reveals anomalies in the structure of cells of epithelial tissue. Timely diagnosis helps to reduce the incidence of women with such a formidable pathology as cervical cancer. All over the world, practicing gynecologists use the PAP-test (Papanicolaou test), the smear should be taken from women aged 18-20 years. Cytology is especially relevant for such categories of patients:

  • Age over 40-45 years.
  • If a woman has a chronic, viral disease.
  • Oncological diseases in the family.
  • Early or late delivery, including frequent delivery.
  • Frequent abortion.
  • Immunodeficiency.
  • Frequent or on the contrary, irregular sexual relations (change of partners).
  • Long period of taking hormonal drugs, including contraceptives.

How is cytology performed?

  • The smear allows you to accurately examine the cellular structure of the cervical epithelium.
  • The material is collected using a medical spatula or brush.
  • The resulting material is placed on a special sterile glass, where it is fixed with a retainer.
  • Glass is labeled and transferred to the laboratory for research.
  • Laboratory assistants carry out staining of the obtained material and study the results of the reaction using a microscope.

Indications for cytology:

  • The main task is to prevent one of the most common diseases in women - cervical cancer (cervical cancer).
  • Determining the cause of failure in the menstrual cycle.
  • Clarification of the state of the cervix in chronic infectious or viral diseases.
  • Persistent sterility.
  • A long period of use of oral medications for contraception.
  • All endocrine diseases.
  • Human papillomavirus in a sexual partner (infection of a woman is almost inevitable).
  • Violation of the norm of weight - anorexia or obesity.
  • Planned procedure for the introduction of the contraceptive spiral.

Cytology largely reduces the development of oncology in women, as well as timely diagnose the initial stages of various pathologies of the cervix.

Cervical dysplasia smear

A smear is considered to be a simple and generally accepted procedure that is included in the complex examination for health or the determination of cervical pathologies.

Cervical dysplasia is often accompanied by, or more precisely, provoked by imbalances in the microflora of the mucous membrane. Bacterial, viral infection may be the primary factor that gives rise to changes in the cell structure of epithelial tissue. A smear on cervical dysplasia shows the number of certain indicators. Smears are of such types:

  • Smear on the determination of the state of microflora.
  • Determination of the sterility of microflora.
  • Cytological smear (PAP-test).
  • Infection smear (PCR).

Also, using a smear on dysplasia, the gynecologist can evaluate some criteria of the state of the hormonal system of the woman.

How is a smear test performed on cervical dysplasia?

  • A gynecological chair collects a small amount of mucus, cellular tissue from the surface layer of the cervical mucosa. The choice of the type of material for analysis depends on the diagnostic task.
  • A swab may be performed several times. Primary is needed to assess the condition of a particular parameter of the cervix, the following to monitor the success of treatment of diseases. If therapy is prolonged, a smear is performed every three months.
  • A smear is considered a painless and quick diagnostic procedure that requires some preparation from the patient (the doctor makes recommendations for preparatory measures).

If a woman is healthy, a smear, as a rule, shows the presence of a large number of lactobacilli (up to 95%). They are able to produce protective, lactic acid, which serves as a barrier to the reproduction of pathogens. The acidity of the microflora is one of the important indicators of the health of the microenvironment in the vagina.

Clarify the tasks for which a smear is performed on cervical dysplasia:

  • The absence or presence of infectious pathogens, including sexually transmitted diseases (trichomonas, chlamydia, gardnerella, etc.).
  • Determination of latent chronic infections (PCR).
  • Evaluation of cervical epithelial cells as a mandatory procedure for the prevention of cervical cancer.

Clean smear can be like this:

  1. Healthy reproductive system, the first group of purity (pH 4.0–4.5).
  2. The second group is an indicator of the initial stage of infection, the presence of gram-negative bacterial flora (pH 4.5–5.0).
  3. Determination of bacterial flora in a smear, the third group (pH 5.0–7.0).
  4. The fourth group is the presence of a critically large number of pathogens (pH 7.0–7.5), a sign of an inflammatory process.

Normally, in a smear on cervical dysplasia there should not be such indicators:

  • The presence of atypical cells.
  • Cells that are infected with infectious agents, key cells (cellular tissue of the squamous epithelium, affected by infectious agents)
  • Candida and other types of fungal pathogens.
  • Gardnerella
  • Coccal bacterial infection (gonococci, staphylococci, streptococci, enterococci).
  • Trichomonas.

If cervical dysplasia is diagnosed as a lesion of the epithelium of the first or second degree of severity, a smear shows the presence of disease agents, this does not mean that the woman has cancer. A huge number of infections in modern medicine have already been studied and successfully treated. Timely detection of pathological changes in the cells of the cervical tissue allows you to prevent cancer in almost 75%, according to some recent data, this percentage increased, thanks to the program of regular screening activities.

Instrumental diagnostics

Instrumental diagnostics is leading in a comprehensive examination, when cervical dysplasia needs to be clarified, as well as to monitor the success of treatment of the disease.

The choice of instrumental evaluation is explained by the fact that dysplasia most often develops and proceeds as a process without clinically noticeable manifestations. In the second place of importance is the laboratory diagnosis. A visual primary examination in a gynecological chair is obligatory, however, it is considered only the first step in diagnosis.

What is included in the list of the concept of "instrumental diagnostics"?

  • Examination using gynecological mirrors. This is a special vaginal instrument that helps the doctor assess the condition of the cervical epithelium. The most obvious changes in the fabric will be visible to the naked eye, subject to the use of mirrors. Instrumental diagnostics in the format of the inspection mirrors shows the shape, size of the neck, as well as possible damage to the external pharynx, tears. Mirrors can evaluate the criteria for the condition of the lower part (third) of the cervix and cervical mucosa. The initial stage of leukoplakia, adnexitis, erosive processes, cervical dysplasia - this is not a complete list of pathologies that can be detected by bimanual studies using vaginal mirrors.
  • Colposcope. Inspection with the help of this tool is designed to clarify the degree of damage to a specific part of the cervix (an increase of 10 times). Also, colposcopy is carried out simultaneously with the collection of tissue for diagnostic tests (cytological tests, biopsy). Kolposkop helps to take and PCR samples (molecular biological, immunological analysis for HIV, assessment of viral load, specification of strains).
  • Extended colposcopy, which may require cervical dysplasia, is divided into several stages. Epithelial tissue is treated with a special acid solution, then another agent is applied again - Lugol solution. Only after this there is an inspection and a special sampling (Schiller's test). Such procedures are necessary for provoking puffiness of the mucous membrane (acid), edema in turn causes increased blood circulation for better permeability of the Lugol solution. This tool plays the role of paint-marker. Normally, epithelial tissue should acquire a reddish hue due to glycogen granules. Any affected area of ​​the cervix will not show a change in color.
  • Ultrasound also belongs to a number of instrumental examinations. To specify the diagnosis, a woman may be prescribed an ultrasound scan of the urogenital organs to exclude or determine cysts, benign tumors, and so on. This method is suitable for young women who have not given birth as an alternative to scraping, scraping.
  • Cytology (Pap test).
  • Standard biopsy and wand - sighting, tapered, curettage - depending on the direction of the complex diagnosis of cervical dysplasia.

Thus, instrumental diagnostics are methods for assessing epithelial tissue and the state of the cervix using medical instruments. When cervical dysplasia in gynecological practice, instrumental and laboratory diagnostics are one of the prerequisites for accurately determining the severity of pathology.

Ultrasound can also be prescribed to the patient if a dysplastic process in the cervix is ​​suspected. Cervical dysplasia in 75-85% of cases develops and proceeds without obvious clinical manifestations. Often it is accompanied by inflammatory processes in the organs of the genital sphere, primarily the ovaries, the uterus, and the kidneys may be affected. This is due mainly to the viral, infectious nature of the factors causing the pathology. The first complaints of women, as a rule, are symptoms of inflammation, and not dysplasia as such. When meeting patients, gynecologists do not get tired of repeating recommendations for routine preventive examinations. Unfortunately, it happens that a woman visits a doctor only when there are pain, discharge, atypical for a healthy state, or during pregnancy. Such situations require more extensive diagnostic actions, including not only standard methods - examination on the chair, but also cytology, material sampling for histology and ultrasound examination.

Ultrasonography to clarify the diagnosis is carried out in a special way - vaginally, in conjunction with ultrasound examination of the genital organs (small pelvis).

What can organ ultrasound show for cervical dysplasia?

  • Cysts of various etiologies, sizes and types (require clarification and treatment).
  • Myomas, fibroids.
  • Tumor benign process.
  • Changes in the size and shape of the uterus.
  • The position of the ovaries in relation to the uterus (the norm or a shift towards pathology).

If the ultrasound of the organs does not show obvious changes, pathological deviations from the norm, young patients, especially those who have not given birth, can be relieved from a more invasive examination - curettage, and even a biopsy.

What is transvaginal ultrasound?

  • This is one of the important examinations in gynecological practice.
  • Transvaginal scanning helps assess the condition of the uterine cavity and its cervix in order to determine the further vector of diagnostic measures.
  • Unlike standard ultrasound, which involves the presence of fluid in the body to conduct a sound wave, the transvaginal method does not require a full bladder.
  • Using this technology, the gynecologist can assess not only the shape and size of the uterus or ovaries, but also more accurately identify the presence of a particular pathology.

Ultrasound and dysplasia of the uterus, how is the examination?

  • The patient does not require special preparation. The rules are almost the same as in the PAP test (abstinence from sexual intercourse, refusal to use candles, tampons, douching).
  • With transvaginal diagnosis, a woman does not need to fill her bladder and endure for a long time.
  • A special sensor is lubricated and inserted into the vagina. Since it is located quite close to the organs under study, the examination itself is considered very reliable and passes quickly.
  • The doctor who performs the ultrasound scan has the opportunity, as they say, to see firsthand a clear clinical picture and assess the condition of the cavities.
  • The procedure does not cause discomfort and pain.
  • The result of the scan is known to the doctor and, in principle, the patient is literally immediately after the procedure.

It should be noted that ultrasound when dysplasia is suspected is most often prescribed in order to assess the condition of the ovaries. This is necessary to exclude the tumor process and the presence of cysts. Also, ultrasound, both classical and vaginal, helps to monitor the success of treatment, especially for persistent infertility.

Diagnostic specificity

Timely and effective diagnosis of cervical dysplasia is half the success in treating pathology. It is worth considering that cervical dysplasia in most clinical cases develops almost asymptomatically, without being accompanied by significant morphological transformations.

The establishment of the considered diagnosis is in itself a neutral event - while the further development of the disease depends solely on the competence of the attending specialist and the patient's readiness to follow medical recommendations.

Therefore, modern gynecology pays considerable attention to the search and development of effective methods for the diagnosis of pathologies aimed at damaging the epithelial tissues of the uterine cavity and appendages. This fully applies to dysplasia. The defeat of this type, localized in the cervix, is a significant threat to the life and health of the patient, because, in essence, is a precancerous condition. The threat of development of oncological formations makes physicians pay special attention to the diagnosis and treatment of manifestations of dysplasia in the cervix, as well as other diseases related to the violation of the structure of epithelial tissues and cell damage.

In cervical dysplasia, the diagnosis involves the use of several basic methods:

  • colposcopy
  • scraping
  • smear microscopy,
  • biopsy
  • method of microscopic examination of bioptic materials.

It should be noted that modern methods of diagnosis of cervical dysplasia are quite effective and allow you to create a complete picture of the development of the disease and its further clinical consequences. Therefore, it is very important to consult a specialist in a timely manner and get professional advice on the nature of the existing lesion and the further development of the pathology.

Colposcopy application

Since cervical dysplasia is associated with inevitable structural and morphological changes in the structure of the cervical epithelial cover, the diagnosis of this disease is based on the identification and interpretation of these manifestations.

Symptoms that develop in case of cervical dysplasia make it possible to accurately determine the degree of development of the pathology and predict its further consequences.

Colposcopy involves instrumental examination of the vaginal canal, and also affects the vaginal part of the uterine cervix. This method is quite effective and painless, but there are certain nuances in its implementation.

In addition, in some clinical cases, extended colposcopy is used, based on the principle of identifying hidden sites of development of the lesion, which represents increased chances for timely treatment and elimination of lesion sites in epithelial tissues.

With extended colposcopy, the diagnostic procedure is performed as follows:

  • the affected tissue is treated with acetic acid (more precisely, its 3% solution is used),
  • then the affected tissues are treated using Lugol solution,
  • mucous membrane of the uterine cervix carefully examined.

This method is used in case of suspicion of latent development of the pathology and its development into malignant lesions. Diagnosis of cervical dysplasia is a rather complex and multi-level process, therefore, during its implementation, a number of factors and features of the development of pathology must be taken into account.

Method of scraping the affected tissue material

In the case when the center of localization of the pathology is the uterine canal, conventional colposcopy may be ineffective for diagnosing cervical dysplasia. In this case, scraping is used to collect cellular material and more thorough analysis of the area of ​​tissue affected by the pathology.

Scraping the uterine canal is carried out using a special curette, and the resulting cellular material is sent for further laboratory research. This method is quite traditional for the diagnosis of cervical dysplasia, and its use allows you to determine the stage of development of the disease, as well as its possible consequences.

However, modern gynecology has abandoned direct and unambiguous ways to diagnose, therefore, scraping is increasingly not the main, but an auxiliary method for diagnosing dysplasia lesions.

After analyzing the obtained biological material, usually a smear of cervical epithelial tissue is taken for further investigation. It is worth noting that the focus in the diagnosis of this type is given to foci of perspective development of cervical dysplasia.

Microscopy

Colposcopy is accompanied by the collection of cellular material, which remains on the swab when taking a smear. The procedure for further research is called Pap smear analysis.

Microscopy of the obtained cellular material allows detecting manifestations characteristic of cervical dysplasia:

  • irregular nuclear shape
  • unevenly distributed chromatin of nuclei,
  • the membrane core in the cell nucleus acquires a clear difference with the chromatin blocks,
  • increase in the size of cell nuclei relative to the cell structure itself.

Microscopy allows not only to identify the pathology of cervical dysplasia, but also to conduct a deep diagnosis of the disease, including the possible clinical consequences of the pathology and associated complications.

Biopsy as a diagnostic method

With cervical biopsy with dysplasia, the possibility of detecting oncological manifestations is 80-90%.

A biopsy is a portion of the lining of the uterine cervix, presumably affected by the pathology in question. The study of this material allows to obtain results indicating the development and nature of the dynamics of the pathology, its possible complications and associated clinical manifestations. In addition, this study allows us to exclude the possibility of the influence of third-party negative factors and concentrate exclusively on the peculiarities of the development of the disease in question.

In gynecologyQuite intensive use of biopsy, given the high efficiency of this method and its relative painlessness.

The tender and sensitive tissue of the uterine cervix epithelium responds moderately to biopsy as a diagnostic method for dysplasia. Biopsy allows not only to determine the stage of development of the disease and predict its further progression, but also determines the morphology and punctuation of the disease.

Carrying out diagnostic measures of this type allows one to accurately and effectively draw up a further course of treatment and eliminate the focus of the development of pathology as soon as possible.

When a biopsy is performed, an analysis of a fragment of mucous tissue is made, the fence of which is performed when performing colposcopic diagnostics. To do this, use special tools that allow the most thoroughly and painlessly to take material.

To continue the study, the biopsy is stained in a characteristic color and placed under a microscope. At the same time, not only the structure of cellular material, but also histoarchitecture itself is subject to evaluation.

Features of the use of biopsy as a diagnostic method

When cervical dysplasia is studied in order to identify possible factors stimulating the development of pathogenic formations and further transformation of cellular material, you should pay attention to a number of factors contributing to the development of malignant lesions.

In particular, the diagnosis of dysplasia is facilitated in the presence of the following factors and circumstances:

  • the layering and maturation of cellular material in the epithelial coating of the uterine cervix are impaired,
  • the outer layers of the epithelium are characterized by a more intense disruption of the maturation process of cellular material,
  • glycogen is synthesized with reduced dynamics for the considered tissue segment,
  • cellular contacts (desmosomes) occur with reduced intensity, their quantitative indicators decrease,
  • ribosomes and mitochondria increase the presence in the analyzed cellular material,
  • growth of cellular material increases,
  • anomalous transformations are characteristic of DNA and mitochondria,
  • squamous epithelium demonstrates an increased tendency to modification - the transformation of cells into a cylindrical and rounded shape is possible.

Thus, the behavior of the biopsy will allow you to accurately diagnose the development of cervical dysplasia, as well as to predict the nature of its further integration into the structure of the patient's gynecological health.

Cytology and pathology

An important element in determining the possibility of cervical dysplasia flowing into oncological manifestation is an analysis of cytology. Conducting the analysis under review allows you to get answers to many questions of concern to patients diagnosed with cervical dysplasia.

The method of cytology is quite specific, and the collection of cellular material may be accompanied by painful sensations.

However, the majority of patients willingly agree to some discomfort, just to clarify the possibility of the prospects for the occurrence of malignant tumors and prevent the development of cervical cancer.

The results of cytological research almost always accurately reflect the possibility of oncological manifestations. In addition, research of this type allows you to optimize the pattern of treatment and identify new ways to eliminate foci of dysplasia damage.

Is the operation painful?

Само по себе лазерное удаление эрозии безболезненно, но дискомфорт безусловно присутствует. Поэтому в большинстве случаев рекомендуется местная анестезия, в качестве которой используется лидокаин.

Препарат наносится непосредственно на шеечную область, но в редких вводится внутривенно.

After a few minutes, the tissues lose their sensitivity, and the doctor can begin the procedure. The effect of anesthesia lasts about half an hour, and this is quite enough to carry out the cautery procedure.

CAUTION! But after the effect of lidocaine has passed, the patient may experience some pain, so the doctor usually prescribes tablets painkillers.

Possible consequences

Negative effects after laser therapy are rarely recorded by doctors, but can sometimes be observed:

  • failure in the menstrual cycle
  • discomfort - heaviness in the lower abdomen,
  • the appearance of uncharacteristic secretions.

If a woman notices a discharge with an unpleasant smell, this is a dangerous symptom that signals the presence of complications. In this case, you should immediately consult a doctor.

Methods of diagnosis of the disease

Cervical dysplasia is diagnosed using various methods. In most cases, it is not enough to apply only one method, so the doctor uses several at once. This approach is called "differential diagnosis." Treatment of the disease is prescribed only after an accurate diagnosis.

Gynecological examination

In this case, the doctor examines the patient's vagina using special gynecological mirrors. The purpose of the procedure is to detect changes in the vaginal mucosa, visible to the eye. These include: the appearance of spots, the growth of the integumentary epithelium, discoloration of the mucous membrane or luster in the area. Usually, after a gynecological examination, only a preliminary diagnosis is made, and the doctor uses other methods for a more accurate diagnosis.

Cytological smear analysis

A cervical cytology smear is a process that identifies abnormalities in the development of cells in the uterus and adjacent organs. This analysis allows us to estimate the number of cells and their sizes. Due to this, the doctor can diagnose the presence or absence of cancer or precancerous diseases of the reproductive system in women.

To smear cytology to be effective and give an accurate result, before going to a specialist, you must meet a number of requirements:

  • do not have sex for 1-2 days before the procedure,
  • eliminate the use of tablets, suppositories or creams of the vaginal type for 2 days prior to analysis,
  • It is not recommended to go to the toilet for 2-3 hours,
  • if there is itching in the vagina, as well as unusual discharge, it is better to postpone the procedure to another day until these symptoms disappear,
  • should be analyzed immediately after the end of the month.

How to take a smear on the PAP test? The procedure is carried out during the examination by a specialist. To do this, use a disposable brush. The process is completely painless and lasts only a few seconds. For several days after taking the test, there may be a slight discharge of blood from the vagina. The results of the analysis should be ready one day after the material is handed over.

Such a test is very effective, because according to the state of the cells, the doctor can determine if the oncological process has begun in the genital area. The doctor makes a diagnosis of cervical dysplasia, if part of the cells has an abnormal size or shape. However, to confirm the diagnosis, the doctor recommends an additional examination.

PCR smear analysis

Analysis of cervical dysplasia by PCR helps to detect the pathogen that cannot be detected by taking an analysis of the microflora. With this method, atypical cells can be found, even if there are still very few of them, and they have just begun to multiply. For the PCR test, a smear test is used for cervical dysplasia or a sample of morning urine.

PCR is a study in which the material taken for analysis is propagated under laboratory conditions. Bacteria DNA is cloned until a complete DNA chain is obtained. In the process of such a procedure, it is revealed which type of infection led to the appearance of the disease.

Diagnosis of cervical dysplasia using this method gives the most accurate result. With it, you can find out not only the genus, but also the type of bacteria. For example, the laboratory assistant not only names the fungus of the genus Candida, but also clarifies - Candida Albicans. This is very important because the treatment of a disease may not be effective if the doctor does not know which bacteria to fight. The procedure allows you to detect a disease of 1 degree, due to which its treatment will be as effective as possible.

Analyzes to determine hormonal homeostasis

Cervical dysplasia may occur as a result of prolonged use of hormonal drugs. Therefore, before you start taking hormonal contraceptives, it is recommended to consult with your gynecologist. As a result of taking hormonal drugs, violations of the hormonal background of the woman are observed, as a result of which she can develop precancerous pathology.

To determine the balance of hormones in the body, a woman should undergo a blood test for the concentration of estrogen, progesterone and testosterone in her. A urinalysis is also recommended to determine the intensity of excretion of the above hormones during urination.

Before passing both tests it is recommended to prepare. Do not smoke or drink alcohol for 3 days before the procedure. Hypothermia or overheating of the body is also not recommended. Taking any medication, especially hormonal, is prohibited. As a result, research results may be inaccurate. It is important not to eat food 10-12 hours before the procedure. Blood for analysis is taken from a vein.

General analysis of blood and urine

Complete blood count is an indispensable method by which the composition of blood is evaluated - red blood cells, white blood cells, platelets, hemoglobin levels are determined. The procedure is carried out in the morning, always on an empty stomach - you can not eat food 10 hours before it. The use of boiled water is allowed. Blood is taken from the finger with a special tool with a sharp tip.

Urinalysis is a procedure by which physicochemical characteristics (presence of protein, nitrite, hemoglobin, and other trace elements) of urine and sediment (red blood cells, epithelial cells, various bacteria) are evaluated. Before passing the analysis it is prohibited to consume alcoholic beverages. Also, do not eat fruits and vegetables, which lead to increased production of urine (watermelon, cantaloupe). A woman during the period of menstruation can not be tested, since blood particles are present in the urine.

It is believed that the most accurate diagnosis of cervical dysplasia is performed using a biopsy. For the procedure, a biopsy is used - the area of ​​the affected tissue, which is obtained by scraping during colposcopy. Biopsy of the cervix with dysplasia 2 and another degree - the procedure is painful, and after it there may be bloody discharge throughout the week.

What does a cervical biopsy show? The diagnosis of dysplasia is made if the following abnormalities were identified during the diagnostic test:

  • disruption of tissue lamination,
  • the presence of atypical or underdeveloped cells,
  • glycogen synthesis is impaired,
  • increased number of ribosomes in the cells.

Such an analysis is very effective in cervical dysplasia. In the process, the laboratory technician assesses not only the structure of the cells, but also the number of layers, their location and composition. A biopsy of the cervix for grade 2 dysplasia helps to make an accurate diagnosis.

Is there any dysplasia on the ultrasound? Yes, ultrasound shows dysplasia. This ultrasound, without which the differential diagnosis of diseases of the reproductive system in women is not performed. The procedure is carried out in several ways:

  • Through the abdominal wall. In this case, dysplasia on ultrasound is quite difficult. However, this method is mandatory for pregnant women and for virgins.
  • The transvaginal method provides more information about the state of the cervix on an ultrasound. In this case, the ultrasound sensor is inserted into the vaginal cavity.
  • The transrectal method allows to assess the structure of the cervical mucosa on ultrasound in girls with preserved virgin chimp.

Ultrasound procedure through the abdominal wall

Decoding data is necessarily carried out by a gynecologist. The results of the study indicate the shape of the cervix, its position, silhouette, wall thickness and size.

Determining the degree of dysplasia

In cervical dysplasia, several stages of the disease are isolated, which depends on the number of atypical cells. At the initial stage, only 1/3 of the mucous membrane is affected, in the case of a moderate degree - 2/3, with a severe form of the disease, the pathological process has spread to 90% of the epithelial layer.

The first degree of dysplasia (light) is considered the weakest, the second is more difficult to heal, but the 3rd degree (severe) is called a precancerous condition. In the case of the first degree of the disease, it is recommended to retake the test after several months to determine if dysplasia progresses.

After the initial examination of the patient, the doctor determines which method is most effective for detecting pathology. All procedures are good, so what kind of tests to appoint a doctor decides depending on the situation. The cost of diagnosis depends on the complexity of the methods used.

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