Uterine dysplasia: what is it, causes, diagnosis, treatment methods

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2024-01-02 05:35

Today, many women of different childbearing ages are faced with a diagnosis of "uterine dysplasia". What it is? Dysplasia refers to abnormal changes in the epithelium in the vaginal area of the uterus. This defect belongs to the category of precancerous diseases. In the early stages, dysplasia is completely reversible, so its timely detection and treatment is the only sure way to prevent the development of oncology.

Unlike the now common erosions that appear against the background of mechanical damage, with dysplasia, the lesion covers the tissues lining the cervix. Most often, this pathology affects women aged 25-35 years. Due to the absence of a pronounced clinical picture in cervical dysplasia of the 1st degree, instrumental and laboratory methods play a major role in the diagnosis. Although often the pathology is discovered quite by accident, during a routine examination on the gynecological chair.

Uterine dysplasia: what is it?

This pathology is an abnormal condition lining the female reproductive organsepithelium, which is characterized by a sharp change in the number of layers and cell structure. This process does not involve the basement membrane and upper structures. Dysplasia is a pathology that, under the influence of certain factors, can cause the emergence of a dangerous tumor.

According to statistics, this disease is the most common precancerous form that can change the structure of the mucous membranes of the vagina and cervix. Its etiology may be different, but pathology absolutely always entails a violation of epithelial cells. It covers not only the upper layers, but penetrates into the deeper layers.

Often dysplasia is called erosion, but in fact this term does not fully correspond to reality. The main difference between these pathologies lies in the fact that the latter appears due to mechanical trauma to tissues, and precancerous is characterized by a violation of the cellular structure.

Forms of the disease and its features

Taking into account the depth of damage to the uterine mucosa, doctors distinguish several types of pathology:

A mild variety, in which about a third of the squamous epithelium is injured - uterine dysplasia of the 1st degree.
The average form, which is characterized by the defeat of most of the epithelial cells - stage 2.
Heavy type, in which all layers are affected - 3rd degree.

Each year, approximately 40 million women around the world are diagnosed with hip dysplasia for the first time or againWhat is it and what are the symptoms of this disease, unfortunately, many representatives of the weaker sex know firsthand. This defect makes up about 16-18% of all diagnosed cervical defects. Most often, women of childbearing age 30 face this diagnosis -35 years old According to medical research, dysplasia turns into a cancerous tumor in about 20-30% of all cases. This is usually characteristic of severe forms of the disease.

Most women, not knowing what it is - uterine dysplasia, and not fully understanding the essence of abnormal mechanisms, confuse this pathology with a simple erosion or tumor. Although in reality neither is true. And in order to understand what the difference is, you should take a closer look at the features of dysplasia and its course.

Reasons

The occurrence and development of uterine dysplasia, like any other precancerous pathology, does not occur under the influence of any one factor. In all cases, the cause of the disease is a combination of many different provoking conditions.

The main prerequisites for the development of dysplasia are:

infection with some papillomaviruses;
long-term use of hormonal oral contraceptives (more than 5 years);
too early onset of sexual activity (around 13-15 years old);
many sexual partners;
all kinds of bad habits, most often smoking.

Among other things, a certain contribution to the development of the diseasemay bring such conditions:

monotonous diet deficient in vitamins A and C;
compromised immunity;
genetic predisposition to cancer;
presence of genital infections;
antisocial behavior;
frequent delivery.

Identification of the leading position of the HPV virus in the onset of dysplasia and malignant neoplasms of the cervix has become a real breakthrough in determining effective methods for combating cancer of the female reproductive system.

Clinical picture

According to numerous reviews, cervical dysplasia in the initial stages is almost asymptomatic, which, of course, makes diagnosis difficult. Pathology manifests itself only in advanced forms: a woman has regular pains in the lower abdomen, there are not abundant bleeding between menstruation. To avoid such phenomena and start therapy on time, you should systematically visit a gynecologist and undergo appropriate examinations. In addition, it is imperative to resort to all necessary clinical, instrumental and laboratory studies.

Usually, signs of uterine dysplasia appear only when the pathology is accompanied by other problems. So, according to doctors, this defect is usually accompanied by erosion. That is why experienced gynecologists without fail send their patients for PAP analysis if such anomalies are detected in them.

Clinical manifestations of any degree of uterine dysplasia can be:

milky abundant discharge without anysmell;
bloody discharge from the vagina after intimacy;
painful intercourse.

It is worth saying again that the symptoms described are not specific and cannot be the basis for a diagnosis of "cervical dysplasia". Such signs can only remind a woman that her reproductive system needs a thorough examination.

Detailed description of the degrees of uterine dysplasia

Like any other disease, this pathology also has several stages of development. As already mentioned, depending on the vastness of the affected area of the epithelium, physicians distinguish 3 degrees of uterine dysplasia. The treatment of the disease largely depends on its form, so determining the stage at the diagnostic stage is extremely important.

The possible consequences of dysplasia are completely determined by its degree. So, a mild form of pathology in most cases is easily treatable and goes away on its own after stopping the virus. In 9 out of 10 he althy women, the pathogenic microflora ceases to be detected in the test results approximately six months after entering the body. Indeed, during this time, immunity gradually destroys viral elements without outside help.

It is noteworthy that in 32% of all cases of the disease, its long course of progress and regression is observed. In 11% of women, there is a smooth transition of the 1st degree of cervical dysplasia to the second.

The average form of pathology in 43% of cases also disappears on its own after stopping HPV. In 35% of patients, there is a long course of cervical dysplasia of the 2nd degree without any changes. According to statistics, 70% of women recover approximately 2 years after diagnosis. 22% of patients face the transition of the 2nd degree of cervical dysplasia to the 3rd.

Severe form often degenerates into cancer.

Dysplasia and pregnancy

This disease is not a contraindication to bearing a child for women who were diagnosed already during the formation of the fetus. The presence of an abnormal process in the tissues of the uterus does not affect the development of the embryo in any way, does not suppress the work of the placenta. At the same time, pregnancy itself does not affect the detected dysplasia, without worsening its course and without contributing to its transition to cancer.

In addition, women should know that under the influence of hormones produced in the body of a future mother, changes can occur on the cervix that often mimic dysplasia. This may be an ectrapion, which is characterized by a shift in the cells of the cervical canal towards the vagina. On examination, such an anomaly looks like a red corolla.

So, if a woman was examined for 1-3 years before conception and received a negative result of a cytological analysis, then a second procedure is not prescribed. If the expectant mother has never undergone such studies, it is recommended to take a smear for a Papanicolaou test at any time. If the test result is positive andthe first degree of dysplasia is diagnosed, then the patient is assigned a colposcopy and a follow-up examination a year after birth.

In case of suspicion of a severe form of pathology, a biopsy is performed. If the result of the analysis confirms the diagnosis, the woman is prescribed a colposcopy every 3 months until the very birth.

Diagnosis

Since dysplasia can degenerate into a tumor under the influence of various factors, the timely detection of the defect plays a major role in the prevention of complications. All women over the age of 20 who are sexually active should undergo a gynecological examination at least once a year. In addition, once every 3 years, a cytological examination is indicated.

In the diagnosis of uterine dysplasia, several popular methods are used:

simple examination by a specialist;
colposcopy;
cytological analysis;
targeted biopsy.

It is noteworthy that the sensitivity of the methods increases many times with an increase in the degree of the disease itself.

Mild treatment

At the initial stage, doctors do not recommend therapy at all. After all, the body fights the disease on its own and, usually, the defect disappears on its own, without the use of medicines.

When 1st degree of dysplasia is detected, the following treatment tactics are prescribed:

active follow-up since diagnosis;
cytological analysis and annualcolposcopy;
fight against existing diseases of the reproductive system;
giving up bad habits;
selection of alternative methods of contraception;
correction of various disorders in the endocrine system.

In view of the fact that there are no special antiviral drugs to eliminate HPV yet, a balanced diet and vitamin complexes can provide maximum support to the body during the period of illness. It is advisable to take drugs containing vitamins B6, C, A, E and B_{12, selenium, folic acid.}

If at the time of the follow-up examination 2 years after the diagnosis, no positive changes are found in the condition of the cervix, it becomes necessary to use more aggressive therapeutic techniques. Small mild lesions are successfully treated with Vagotid and Solkogin, which treat damaged areas.

Treatment of cervical dysplasia grades 3 and 2

Therapy of advanced stages of pathology involves the use of surgical techniques:

moxibustion;
radio wave procedures;
cryolysis;
photodynamic events;
laser application;
electroconization.

Surgery should be carried out immediately after the end of menstruation - this way you can prevent endometriosis and accelerate tissue regeneration. Immediately prior to surgical procedures, it is mandatory to perform colposcopy, biopsy andcytological examination.

Treatment of uterine dysplasia by cauterization involves a special procedure using special equipment with loop electrodes. During the operation, under the influence of current, the modified cells are destroyed. The advantages of this technique include its availability, ease of implementation and relative cheapness. but the disadvantages of cauterization are large scars after tissue regeneration, the inability to control the depth of current penetration, a greater likelihood of developing endometriosis.

Treatment of uterine dysplasia using cryodestruction is carried out by instant freezing of modified epithelial cells under the influence of liquid nitrogen. The advantage of this procedure is that there are no scars. It is thanks to this feature that cryodestruction can be prescribed to nulliparous women. As for the disadvantages, these include the appearance of abundant abnormal discharge, the need for sexual abstinence for up to 2 months, the inability to control the depth of processing.

Laser is often used in the treatment of grade 3 cervical dysplasia. The basis of this technique is the disappearance of affected tissues under the influence of special equipment. After such an intervention, a woman does not have scars, modern devices give doctors the opportunity to monitor the depth of penetration of the rays, due to which you can easily get rid of all damaged layers. True, due to the use of a laser, burns canappear on adjacent he althy tissues. It is noteworthy that anesthesia may be required for this procedure, since its effectiveness is determined by the immobility of the woman.

Radio wave therapy is considered a modern technique, which is based on the impact of high-frequency waves on damaged areas. This procedure has a lot of advantages:

minor injury;
absolute painlessness;
quick recovery;
ability to control the depth of wave penetration;
no scars;
minimum relapse rate;
possibility to use for the treatment of nulliparous women.

But there is only one drawback of this operation - the high cost and availability only in private clinics. True, according to reviews, this procedure is the most effective in the treatment of dysplasia.

Excision involves the removal of modified tissues using a special apparatus or a simple scalpel. Due to the rather large trauma and numerous complications after surgery, it is not used in the treatment of women of childbearing age.

Photodynamic treatment is considered one of the modern ways to eliminate cervical dysplasia. After it, all cancer cells die in the woman's body. The technique itself involves irradiating tumors with special light.