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Uterus neck dysplasia

Understand the atipichesky changes of an epithelium in its vaginal part relating to precancer processes as a dysplasia of a neck of a uterus. At early stages of the development the dysplasia of a neck of a uterus is a reversible disease therefore its timely detection and elimination is a reliable way of prevention of oncological risk. Unlike the erosion arising at mechanical traumatizing fabrics at a dysplasia of violation mention cellular structures of the fabrics covering a uterus neck. The disease of a dysplasia of a neck of a uterus is necessary, generally on age of 25-35 years and makes 1,5 cases on 1000 women. Lack of obvious clinical symptoms at a uterus neck dysplasia into the forefront in diagnostics puts tool, clinical and laboratory techniques.

Uterus neck dysplasia

Understand the atipichesky changes of an epithelium in its vaginal part relating to precancer processes as a dysplasia of a neck of a uterus. At early stages of the development the dysplasia of a neck of a uterus is a reversible disease therefore its timely detection and elimination is a reliable way of prevention of oncological risk.

Unlike the erosion arising at mechanical traumatizing fabrics at a dysplasia of violation mention cellular structures of the fabrics covering a uterus neck. The disease of a dysplasia of a neck of a uterus is necessary, generally on age of 25-35 years and makes 1,5 cases on 1000 women. For understanding, the pathological processes happening at a uterus neck dysplasia it is necessary to make idea of features of its anatomo-physiological structure.

Types of a dysplasia of a neck of a uterus

The lower, narrow, cylindrical department of a uterus which is partially located in an abdominal cavity and partially pressing in a vagina (respectively a nadvlagalishchny and vaginal part), represents a uterus neck.

Vaginal part of a neck of a uterus is surveyed by means of vaginal mirrors during gynecologic survey. Inside on a neck of a uterus there passes the narrow tservikalny (cervical) channel 1-1,5 cm long, one end of which (an external pharynx) opens in a vagina, and another (an internal pharynx) – in a uterus cavity, connecting them.

From within the tservikalny channel is covered by a layer of epitelialny cylindrical cages and contains the cervical glands producing slime. The mucous secret of the cervical channel interferes with a microflora drift from a vagina in a uterus. Epitelialny cylindrical cages have bright red color.

In a zone of an external uterine pharynx epitelialny cylindrical cages of the cervical channel pass into the multilayered flat epithelium which is covering walls of a vagina, a vaginal part of a neck of a uterus and not having glands. The flat epithelium is painted in light pink color and has the multilayered structure consisting from:

  • basal and parabasal layer - the lowermost, deep layer of the epithelium formed by basal and parabasal cages. The basal layer of a flat epithelium borders on the below-located fabrics (muscles, vessels, the nervous terminations) and contains the young cages capable to reproduction by division;
  • intermediate layer;
  • functional (superficial) layer.

It is normal of a cage of a basal layer of rounded shape, with one large round kernel. Gradually ripening and moving to intermediate and superficial layers, the form of basal cages is flattened, and the kernel decreases in a size. Having reached a blanket, cages become flattened with very small kernel.

The dysplasia of a neck of a uterus is characterized by violations in structure of the cells and layers of a flat epithelium. The changed epitelialny cages become atypical – large, shapeless, with multiple kernels and disappearance of division of an epithelium into layers.

The dysplasia of a neck of a uterus can affect various layers of cages of a flat epithelium. Allocate 3 degrees of a dysplasia of a neck of a uterus depending on depth of pathological process. The more layers of an epithelium it is struck, the uterus neck dysplasia degree is heavier. On the international classification allocate:

  1. Slight dysplasia of a neck of a uterus (CIN I, a dysplasia І) – changes in structure of the cells are expressed poorly and affect the lower third of a multilayered flat epithelium.
  2. Moderate dysplasia of a neck of a uterus (CIN II, a dysplasia ІІ) – changes in structure of the cells are observed in the lower and average third of thickness of a flat epithelium.
  3. Heavy dysplasia of a neck of a uterus or noninvasive cancer (CIN III, a dysplasia ІІІ) – pathological changes meet in all thickness of epitelialny cages, but do not extend to vessels, muscles, the nervous terminations, as at the invasive cancer of a neck of a uterus affecting these structures.

Uterus neck dysplasia reasons

Most often development of a dysplasia of a neck of a uterus is caused by onkogenny types of a virus of papilloma of the person (VPCh-16 and VPCh-18). This reason is established at 95-98% of patients with a uterus neck dysplasia. At long stay in an organism and cages of a flat epithelium (1-1,5 years), the human papillomavirus infection causes changes in structure of the cells, i.e. a dysplasia. It is promoted by some burdening background factors:

  • immunodeficiency – suppression of immune responsiveness chronic diseases, stresses, medicines, improper feeding etc.;
  • tobacco smoking active and passive – increases probability of development of a dysplasia of a neck of a uterus by 4 times;
  • long chronic inflammations of genitals;
  • the violations of a hormonal background caused by a menopause, pregnancy, the use of gormonosoderzhashchy drugs;
  • early sex life and childbirth;
  • traumatic injuries of a neck of a uterus.

Uterus neck dysplasia symptoms

The uterus neck dysplasia practically does not give an independent clinical picture. The hidden course of a dysplasia is observed at 10% of women. Much more often the microbic infection causing pathological symptoms of a colpitis or a tservitsit joins a dysplasia of a neck of a uterus: burning or an itch, allocations from a genital tract of unusual color, a consistence or smell, sometimes with blood impurity (after use of tampons, sexual intercourse, etc.). Pain at a uterus neck dysplasia practically is always absent. A dysplasia of a neck of a uterus can have a long current and independently regress after the corresponding treatment of inflammatory processes. However, usually process of a dysplasia of a neck of a uterus carries the progressing current.

The uterus neck dysplasia often proceeds together with such diseases as peaked condylomas of a vagina, vulva, back pass, clamidiosis, gonorrhea.

Lack of obvious clinical symptoms at a uterus neck dysplasia into the forefront in diagnostics puts tool, clinical and laboratory techniques.

Methods of diagnosis of a dysplasia of a neck of a uterus

The scheme of diagnosis of a dysplasia of a neck of a uterus consists from:

  • survey of a neck of a uterus by means of vaginal mirrors – for the purpose of detection of the dysplasia forms seen by an eye, clinically expressed (change of coloring mucous, gloss around an external pharynx, a spot, growth of an epithelium, etc.);
  • kolposkopiya – survey of a neck of a uterus kolposkopy – the optical apparatus enlarging the image more than by 10 times and simultaneous conducting diagnostic tests - processings of a neck of a uterus solution of Lugol and acetic acid;
  • cytologic research of FATHERS dabs – at a uterus neck dysplasia the research under a microscope of the scrape received from different sites allows to reveal atypical cages. Also by means of FATHERS dabs the human papillomavirus infection cells markers having the wrinkled kernels and the rim which are the place of localization of a virus of papilloma of the person are found;
  • histologic research of a bioptat – the fragment of fabric taken during a uterus neck biopsy from a zone, suspicious on a dysplasia. Is the most informative method of detection of a dysplasia of a neck of a uterus;
  • immunological PTsR-methods – for detection of the VPCh-infection, establishment of strains of a virus and virus loading (concentration of a virus of papilloma in an organism). Identification of existence or lack of the VPCh onkogenny types allows to define the choice of a method of treatment and tactics of maintaining the patient with a uterus neck dysplasia.

Treatment of a dysplasia of a neck of a uterus

The choice of a way of treatment of a dysplasia of a neck of a uterus is defined by dysplasia degree, age of the woman, the defeat zone size, associated diseases, intentions of the patient to keep genital function. The leading place in treatment of a dysplasia of a neck of a uterus is taken:

  1. The immunostimulating therapy (immunomodulators, interferona and their inductors) – are shown at extensive damages and the course of a dysplasia of a neck of a uterus inclined to a recurrence.
  2. Methods of surgical intervention:
  • destruction (removal) of the atypical site by means of cryotherapy (influence by liquid nitrogen), electrothermic coagulations, radio wave therapy, the argon or carbonic laser;
  • expeditious removal of a zone of a dysplasia of a neck of a uterus (konization) or all neck of a uterus (amputation).

At dysplasia degree І and ІІ, the small sizes of the changed zone, young age of the patient waiting tactics in view of high probability of independent regress of a dysplasia of a neck of a uterus often is chosen. Carrying out repeated (each 3-4 months) cytologic researches and obtaining two positive results confirming existence of a dysplasia of a neck of a uterus is the indication to the solution of a question of surgical treatment. Treatment of a dysplasia ІІІ is carried out by onkoginekolog, with use of one of surgical ways (including cone-shaped amputation of a neck of a uterus).

Before carrying out any of ways of surgical treatment of a dysplasia of a neck of a uterus the course of the anti-inflammatory therapy directed to sanitation of the infectious center is appointed. As a result of it degree of a dysplasia of a neck of a uterus quite often decreases or there is its full elimination.

Surgical treatment of a dysplasia of a neck of a uterus

After performing surgical treatment of a dysplasia of a neck of a uterus the period of rehabilitation lasts about 4 weeks. At this time can be noted:

  • pains of the aching character in the bottom of a stomach for 3-5 days (is longest – after destruction by the laser);
  • allocations from a genital tract - plentiful, sometimes with a smell for 3-4 weeks (is longest - after carrying out cryodestruction);
  • plentiful, long bleeding from genitals, intensive pains in the bottom of a stomach, rise in body temperature to 38 °C and above – serve as indications for immediate medical consultation.

For the purpose of the speedy recovery, more bystry healing and prevention of complications, respect for sexual rest, an exception of syringings, heavy lifting, use of hygienic tampons and exact implementation of all recommendations and appointments of the doctor is necessary.

Observation and prevention of a dysplasia of a neck of a uterus

The first control of an izlechennost of a dysplasia of a neck of a uterus is carried out 3-4 months later after surgical treatment. Cytologic dabs with the subsequent quarterly repetitions within a year undertake. The negative results showing absence of a dysplasia of a neck of a uterus allow to conduct further examination according to plan, at annual dispensary surveys.

For prevention of a dysplasia of a neck of a uterus and its recurrence it is recommended:

  • inclusion in a food allowance of all minerals and vitamins, in particular vitamins A, group B, selenium;
  • timely sanitation of all centers of infections;
  • refusal of tobacco smoking;
  • application of barrier contraception (at casual sexual contacts);
  • regular observation of the gynecologist (1-2 times a year) with a research of cytologic scrape from a uterus neck.

Prospects of treatment of a dysplasia of a neck of a uterus

The modern gynecology has the effective methods of diagnostics and treatment of a dysplasia of a neck of a uterus allowing to avoid its regeneration in cancer. Early detection of a dysplasia of a neck of a uterus, the corresponding diagnostics and treatment, further regular medical control allow to cure practically any stage of a disease. After application of surgical techniques the frequency of an izlechennost of a dysplasia of a neck of a uterus makes 86-95%. The recurrent course of a dysplasia of a neck of a uterus is observed at 5-10% of the patients who transferred surgical intervention owing to a carriage of a papillomavirus of the person or incomplete excision of the pathological site. In the absence of treatment of 30-50% of displaziya of a neck of a uterus regenerate in invasive cancer.

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