2nd degree cervical dysplasia

Changes in the cellular structures of the mucous membranes of the cervix are called dysplasia. This painful condition is divided into several degrees, which depends on the depth of tissue damage and the size of the pathological focus. In this article, we will consider what grade 2 cervical dysplasia is - specialists assess this degree as moderate, when the painful process affects approximately 2/3 of the entire thickness of the epithelial tissue.

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Causes grade 2 cervical dysplasia

The fact that the human papillomavirus influences the development of dysplasia has now been scientifically proven. In 2008, Harald zur Hausen was awarded the Nobel Prize for his discovery of the papillomavirus.

The pathogenesis of the disease has been fully studied. After infection with HPV, good immunity should cope with the infectious invasion. But in some patients, virus subtypes 6 and 11 provoke the development of cervical dysplasia. There is also a certain list of oncogenic subtypes that can cause severe dysplasia and even cancerous degeneration of cells. The greatest danger is posed by viruses 16 and 18.

Several years may pass from the moment the virus enters the body until the disease develops, but experts have identified certain unfavorable factors that can speed up this process:

• promiscuous sex life;
• early sexual activity;
• sexually transmitted diseases (chlamydia, gonorrhea, HIV, syphilis, etc.);
• more than five pregnancies ending in childbirth;
• weak immunity, immunodeficiency state (for example, after transplant operations or chemotherapy);
• bad habits (nicotine increases the harmful effects of the papillomavirus).

The development of dysplasia is a slow but progressive process, which in the initial stages tends to heal on its own.

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Symptoms grade 2 cervical dysplasia

Stage 2 cervical dysplasia may not reveal itself at all and may not show any symptoms. About 10% of patients have latent (hidden) development of the disease.

If bacterial pathology (infection) joins dysplasia, the first signs of the disease may appear, reminiscent of the clinical picture of colpitis or endocervicitis:

• itching and burning sensation in the vagina;
• the appearance of discharge from the genitals;
• The discharge may have a different smell, shade, and sometimes contain blood (especially after sexual contact or using tampons).

In the vast majority of cases, there is no pain associated with dysplasia.

Stage 2 dysplasia tends to resolve itself if the body has a strong enough immune defense. Otherwise, the disease gradually progresses.

Often, damage to the tissues of the cervix develops against the background of gonorrhea, condylomatosis, chlamydia.

In asymptomatic cases, it is very important to conduct high-quality laboratory and clinical diagnostic measures.

Cervical dysplasia grade 2 and pregnancy

Cervical dysplasia is a very serious pathology that can not only worsen the condition of the reproductive system, but can also lead to the development of cancer.

Experts consider grade 2 cervical dysplasia and pregnancy to be compatible: according to statistics, in most cases it does not pose serious consequences and does not harm the child's health. However, during pregnancy, dysplasia may continue to progress - for example, from grade 2 to grade 3. Despite this, treatment of the disease in pregnant women is not carried out.

At the stage of pregnancy planning, a woman should undergo general diagnostic procedures to assess her health. By the way, if pathological damage to the tissues of the cervix appeared as a result of hormonal disorders, then pregnancy can lead to self-healing of the disease.

If the patient has been diagnosed with papillomavirus or condylomas, the disease should be treated before pregnancy. If dysplasia or condylomas were detected when the woman was already pregnant, she will most likely be offered to give birth to the baby by cesarean section. This will protect the child from infection with the papilloma virus. Treatment of the patient herself will be postponed until the postpartum period, so as not to put the child at risk and not to worsen the problem.

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Stages

• N 87.0 – mild degree of dysplasia (grade 1).
• N 87.1 – moderate degree of dysplasia (grade 2).
• N 87.9 – unspecified degree of dysplasia.

Complications and consequences

Cervical dysplasia of the 2nd degree in more than 40% of cases is cured spontaneously after the destruction of the papillomavirus in the body.

In more than 30% of cases, the disease becomes long-term, stable and sluggish. Therefore, approximately 70% of patients experience a stable recovery after 1-3 years from the time of diagnosis.

In more than 20% of patients, grade 2 dysplasia transforms into grade 3, which, in turn, in 20-30% of cases transforms into a cancerous tumor.

Treatment of grade 2 dysplasia can also result in some complications:

• development of bleeding (mainly after surgery);
• formation of scars and complications of labor (narrowing of the cervical lumen, loss of elasticity of the cervix, rupture of the canal, labor bleeding);
• recurrent development of dysplasia (explained by the presence of the papilloma virus in the body);
• infection (due to failure to observe hygiene rules or as a result of unprotected sexual contact).

In general, the prognosis for stage 2 cervical dysplasia is relatively favorable, since this stage does not yet refer to a potentially precancerous condition. Timely measures in most cases allow to overcome the disease completely.

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Diagnostics grade 2 cervical dysplasia

The colposcopy method is a way to examine the mucous tissues of the vagina and cervix. There is also an extended version of this procedure, which is carried out in stages:

• First, the doctor treats the cervix with 3% acetic acid;
• additionally treated with 3% Lugol's solution;
• conducts an inspection.

Under the influence of acetic acid, tissue edema occurs, and the blood supply to the mucous membrane decreases. Lugol's solution changes the color of glycogen granules. If uncolored areas remain on the epithelium, this may raise suspicion of dysplasia.

The cervical curettage procedure is performed in cases where a regular colposcopy does not allow the required amount of material to be taken. After curettage, the removed tissues are sent for laboratory testing.

A smear from the cervical mucosa is taken for microscopy, which determines the typical signs of the disease:

• shapeless nuclei, abnormal distribution of chromatin;
• smooth contours of chromatin lumps and membranous core;
• a nucleus that is enlarged in size relative to the cell itself.

A biopsy with subsequent microscopic examination is the taking of a mucosal element using instruments during a colposcopy. After this, the tissue is sent for analysis, which will determine the condition of the cellular structures and layers of the mucosa. A biopsy can not only confirm or refute the diagnosis, but also assess the extent of the lesion. •

Examination of the cervix in mirrors makes it possible to see changes in the color of the mucous membrane, pathological growths of epithelial tissue, the presence of spots, and shine around the circumference of the external os.

During pregnancy, instrumental diagnostics may consist only of colposcopy, since biopsy is not performed during this period. This examination may be prescribed only 45 days after delivery. At that time, cytological and histological examination of tissues is appropriate.

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Differential diagnosis

Differential diagnostics are carried out with cervical erosion and cancer:

• during erosion, the mucous layer is destroyed under the influence of certain factors, or due to a disorder in tissue trophism;
• In cancerous tumors, the proliferation of atypical cells in tissues is observed.

Treatment grade 2 cervical dysplasia

Before starting treatment of dysplasia, it is necessary to understand and eliminate the cause of the disease - this may be hormonal imbalances, viral invasion or infectious and inflammatory reactions. Sometimes this action alone is enough to promote regression of the disease. If the effect does not occur, then the patient will be prescribed one of the methods of surgical intervention. •

Medicines for dysplasia can only be prescribed simultaneously with other treatment methods. Usually, the purpose of prescribing medicines is to stimulate immunity and destroy viruses, which are the main cause of the disease.

• Immunostimulating drugs (isoprinosine, reaferon, prodigiosan).
• Vitamin and mineral preparations (folic acid, vitamin A, tocopherol, ascorbic acid, selenium). •

Traditional treatment for dysplasia is allowed to be used in addition to the main treatment - this will help to alleviate the patient's well-being.

• Aloe juice is used for tampons: the lower leaf of aloe (at least 3 years old) is crushed and the juice is squeezed out, in which a tampon is moistened and placed in the vaginal cavity for half an hour. The procedure is repeated twice a day for 4 weeks. Such a medicine helps to strengthen tissue protection and accelerate wound healing.
• A mixture of 50 g of calendula, 40 g of rose hips, 40 g of nettle and the same amount of yarrow will relieve inflammation and speed up local metabolism. To prepare the medicine, brew 1 teaspoon of the mixture in 250 ml of boiling water and douche three times a day.
• Sea buckthorn oil strengthens the tissues of the vagina and cervix, restores the mucous membrane. The therapeutic effect is provided by tampons soaked in oil and inserted into the vagina overnight. Duration of therapy is 3-4 weeks.
• Propolis is used in the form of an ointment: 10 g of propolis is mixed with 100 g of melted butter, heated in a water bath for 20 minutes. A tampon is soaked in the resulting mass and placed in the vagina for 20 minutes in the morning and evening. Duration of treatment is 3-4 weeks.

It should not be forgotten that any herbal treatment must be agreed upon and approved by the attending physician. •

Homeopathy is an alternative form of treatment that is just beginning its journey in Russian medicine. Adherents of homeopathy claim that homeopathic medicines are safe, effective and affordable. In particular, for the treatment of dysplasia and papillomavirus infection, a medicine such as Acidum nitricum is recommended - it is prescribed 5 granules or 5-10 drops between meals, in the morning and at night. The drug promotes the healing of erosive and ulcerative surfaces, cracks that are difficult to treat. •

Surgical treatment is prescribed in the first phase of the monthly cycle. The method is selected by the doctor strictly individually, after a thorough diagnosis.

• The cauterization method is based on the fact that the modified cells are destroyed by the current. A special device with loop electrodes is used to perform the procedure. This method is accessible and easy to use, but can leave scars and contribute to the development of endometriosis.
• The cryodestruction method involves freezing tissues with liquid nitrogen. Epithelial cells that have been frozen die. Scars do not form after this procedure, which allows a woman to think about pregnancy in the future. After treatment, discharge may appear, which disappears in about a month.
• Laser therapy is the evaporation of damaged tissue with a laser beam. The method is good because it does not leave rough scars, and the damaged cells are completely removed. However, simultaneous damage to healthy tissues is possible, which will lead to their necrosis.
• Radio wave therapy involves exposure to high-frequency radio waves using Surgitron equipment. The procedure is minimally invasive, painless, healing occurs quickly and with virtually no relapses. The only downside to radio wave therapy is its high cost.
• Surgical excision (conization method) is the surgical removal of damaged tissue with a scalpel or laser. As a rule, it is not used in women who plan to have children.

Nutrition for cervical dysplasia grade 2

A special diet for dysplasia will help alleviate the patient's condition and slow down the development of the pathology, as well as reduce the risk of the disease transforming into a cancerous tumor.

In order to defeat the papilloma virus that causes the disease, it is important to increase the effectiveness of the immune defense in the body. To do this, you should ensure adequate nutrition, with sufficient amounts of vitamins and minerals. Deficiency of some vitamins and microelements can reduce the protective function, which will serve as an impetus for the spread of viral infection.

What should be excluded from the diet:

• smoked and fried foods;
• alcohol;
• spicy food;
• GMO products;
• sugar and sweets.

It is recommended to eat foods with a high content of vitamins, which help restore damaged tissue and strengthen the immune system.

Folic acid is found in the following foods:

• green;
• legumes;
• citrus;
• bananas;
• cabbage;
• cereals (buckwheat and millet);
• walnuts.

Retinol (vit. A) is found in:

• in the liver;
• in butter and dairy products;
• in seaweed;
• in fish.

Ascorbic acid can be found:

• in kiwi fruits;
• in bell peppers;
• in all types of cabbage;
• in citrus fruits;
• in sorrel;
• in radishes;
• in currants and raspberries.

Tocopherol (vitamin E) is rich in:

• vegetable and butter oils;
• green;
• nuts;
• dried fruits;
• buckwheat, peas;
• salmon.

In case of dysplasia, it is useful to consume products with β-carotene:

• carrot;
• cabbage, lettuce leaves;
• pumpkin;
• sweet potato;
• apricots, peaches, cherry plums.

The body also needs selenium, which activates the immune system and reduces the risk of developing cancer:

• chicken eggs;
• legumes;
• peanut;
• celery root;
• corn;
• rice groats;
• cabbage.

It is recommended to adhere to the principles of healthy eating: do not eat fast food, semi-finished products, products with chemical additives. It is also advisable to establish a drinking regime: you can drink clean still water and green tea, rich in antioxidants.

Prevention

Specific prevention of dysplasia consists of vaccination against papillomaviruses of types 16 and 18. These types of the virus are considered the most dangerous and can provoke the development of dysplasia and oncological diseases of the cervix. Administration of a special vaccine significantly reduces the risk of developing pathology.

Non-specific prevention involves:

• maintaining purity of sexual relations, preventing venereal diseases;
• providing the body with folic acid;
• complete and rational nutrition;
• regular visits to the doctor, regular examinations of the reproductive system.

In addition, it is not recommended to overuse tanning. Also, you should not introduce any products or liquids into the vagina that are not prescribed by a doctor.

Stage 2 cervical dysplasia is mostly asymptomatic, which often causes patients to seek medical help late. For this reason, doctors recommend regular visits to the gynecologist for preventive purposes. This will allow dangerous diseases to be detected in time.

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