Cervical dysplasia of the 2nd degree

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 constitutes cervical dysplasia of the 2nd degree - experts estimate a degree as moderate when the painful process affects about 2/3 of the entire thickness of the epithelial tissue.

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Causes of the cervical dysplasia of the 2nd degree

At present, the scientifically proven fact of the influence of human papillomavirus on the development of dysplasia. In 2008, Harald Zur Hausen was awarded the Nobel Prize for the discovery associated with papillomavirus.

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

Since the moment of the virus's penetration into the body, several years can pass before the disease develops, however, certain unfavorable factors are identified by specialists that can accelerate this process:

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

The development of dysplasia is a slow but growing process, at the initial stages prone to self-healing.

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Symptoms of the cervical dysplasia of the 2nd degree

Cervical dysplasia of grade 2 may not detect itself at all and show no symptoms. About 10% of patients have a latent (latent) development of the disease.

If bacterial pathology (infection) is attached to the dysplasia, then the first signs of the disease may appear, resembling the clinical picture of colpitis or endocervicitis:

• sensation of itching and burning in the vagina;
• the appearance of a genital secretion;
• detachable can have a different smell, shade, sometimes - an admixture of blood (especially after sexual contact or use of tampons).

Painful sensations for dysplasia in the vast majority of cases are absent.

Dysplasia of the 2 nd degree has the property of eliminating itself, in case the body has a sufficiently strong immune defense. Otherwise, the disease gradually progresses.

Often damage to the cervical tissue develops against the background of gonorrhea, condylomatosis, chlamydia.

With asymptomatic flow, it is very important to conduct quality laboratory and clinical diagnostic activities.

Cervical dysplasia of the 2nd degree and pregnancy

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

Cervical dysplasia of the 2nd degree and pregnancy specialists are considered compatible: according to statistics, in most cases this does not threaten with serious consequences and does not harm the child's health. However, during gestation, dysplasia can continue to progress - for example, from the second degree go to the third. Despite this, treatment of the disease in pregnant women is not carried out.

At the stage of pregnancy planning, a woman must undergo general diagnostic procedures to assess her health. By the way, if pathological damage to the cervical tissues appeared due to hormonal disorders, it is pregnancy that can lead to self-healing of the disease.

In the event that the patient has been identified papillomavirus or found condylomata, the disease must be treated before the onset of pregnancy. If dysplasia or condylomata have been identified, when the woman has already become pregnant, she will most likely be offered to give birth to a baby with the help of caesarean section. This will protect the child from infection with the papilloma virus. Treatment of the same patient will be postponed to the postpartum period in order not to expose the child to 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 2 degrees more than 40% of cases is cured spontaneously after the destruction in the body of papillomavirus.

More than 30% of cases become long-lasting, stable and sluggish. Therefore, approximately 70% of patients experience a stable recovery 1-3 years after the diagnosis.

More than 20% of patients with grade 2 dysplasia are converted to grade 3, which in turn, in 20-30% of cases, is transformed 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 complication of labor (narrowing the lumen of the cervix, loss of elasticity of the neck, rupture of the canal, birth bleeding);
• repeated development of dysplasia (due to the presence of the papilloma virus in the body);
• Attachment of infection (due to non-compliance with hygiene rules or as a result of unprotected sex).

In general, the prognosis of cervical dysplasia of the 2nd degree is relatively favorable, since this degree is not yet related to the potentially precancerous state. Timely measures in most cases allow to overcome the disease completely.

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Diagnostics of the cervical dysplasia of the 2nd degree

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

• First the doctor treats the neck with 3% acetic acid;
• additionally processes 3% of Lugol's formula;
• conducts an inspection.

Under the influence of acetic acid, tissue swelling occurs, and the blood supply to the mucosa decreases. Lugol's solution changes the color of glycogen granules. If unpainted areas remain on the epithelium, then this can cause suspicion of dysplasia.

The procedure for scraping the cervix is carried out in cases where conventional colposcopy does not allow you to take the right amount of material. After curettage, the withdrawn tissues are sent to a laboratory test.

A smear with cervical mucosa is taken to conduct a microscope that identifies typical for the disease signs:

• formless nuclei, irregular distribution of chromatin;
• smooth contours of blocks of chromatin and membrane core;
• Increased in size core relative to the cell itself.

A biopsy with further microscopic examination is the taking of an element of the mucosa with instruments during colposcopy. After that, the tissue is sent for analysis, which will allow to determine the state of cellular structures and layers of mucosa. A biopsy can not only confirm or disprove the diagnosis, but also assess the extent of the lesion. •

Inspection of the cervix in the mirrors makes it possible to see the discoloration of the mucosa, the pathological growths of the epithelial tissue, the presence of spots, shine along the circumference of the external pharynx.

During pregnancy, instrumental diagnostics can consist only of colposcopy, since there is no biopsy in this period. This study can be scheduled only 45 days after delivery. At the same time, cytological and histological examination of tissues is appropriate.

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Differential diagnosis

Differential diagnosis is performed with cervical erosion and cancer:

• when erosion, the mucosal layer is destroyed under the influence of some factors, or in the case of trophic tissue disorder;
• In cancerous tumor, the growth of atypical cells in tissues is observed.

Treatment of the cervical dysplasia of the 2nd degree

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

Medications for dysplasia can be prescribed only at the same time as other therapeutic 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, prodigiozan).
• Vitamin and mineral preparations (folic acid, vitamin A, tocopherol, ascorbic acid, selenium). •

Alternative treatment for dysplasia is allowed for use against the background of the main treatment - this will help ease the patient's well-being.

• Aloe juice is used to set tampons: the lower leaf of aloe (at least 3 years of age) is crushed and squeezed out the juice in which a tampon is moistened and put into the vagina cavity for half an hour. The procedure is repeated twice a day for 4 weeks. Such a drug helps to strengthen tissue protection and accelerate wound healing.
• Collection, which includes 50 g of calendula, 40 g of rose hips, 40 g of nettle and the same yarrow, will remove the inflammatory process, accelerate the local metabolism. To prepare the medicine, brew 1 tsp. Mixture in 250 ml of boiling water and syringed three times a day.
• Sea-buckthorn oil strengthens the tissues of the vagina and cervix, restores the mucous membrane. The therapeutic effect of tampons, moistened in oil and inserted into the vagina at night. The duration of therapy is 3-4 weeks.
• Propolis is used as an ointment: 10 g of propolis per 100 grams of melted butter is mixed, heated in a water bath for 20 minutes. In the resulting mass, a tampon is wetted and placed in the vagina for 20 minutes. In the morning and in the evening. Duration of treatment is 3-4 weeks.

Do not forget that any herbal treatment should be agreed and approved by the treating doctor. •

Homeopathy is an alternative type of treatment, which for the present only begins its journey in domestic medicine. Adherents of homeopathy claim that homeopathic remedies are safe, effective and accessible. In particular, for the treatment of dysplasia and papillomavirus infection, a drug such as Acidum nitricum is recommended - it is prescribed for 5 granules or 5-10 drops between meals, in the morning and overnight. The drug promotes the healing of erosive and ulcerative surfaces, cracks that are difficult to treat. •

Operative treatment is assigned in the first phase of the monthly cycle. The technique is selected by the doctor strictly individually, after careful diagnosis.

• The method of cauterization is based on the fact that the modified cells undergo a destruction under the influence of current. A special device with loop electrodes is used for the procedure. This method is available and easy to use, but it can leave scarring and promote the development of endometriosis.
• The method of cryodestruction is the freezing of tissues by liquid nitrogen. Epithelial cells that have undergone freezing die. Scars after such a procedure are not formed, which allows a woman in the future to think about pregnancy. After treatment, there may be a discharge that lasts about a month.
• Laser therapy is the evaporation of damaged tissue by a laser beam. The method is good because after it no rough scars remain, and the affected cells are removed completely. However, simultaneous damage to healthy tissues is also possible, which entails necrosis.
• Radiowave therapy provides for exposure to high-frequency radio waves using Surgitron equipment. The procedure is minimally invasive, painless, healing occurs quickly and practically without relapses. The only drawback of radio wave therapy is its high cost.
• Surgical excision (the method of conization) is the rapid 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 of the 2nd degree

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

In order to defeat the papilloma virus, which provokes the disease, it is important to increase the effectiveness of immune defense in the body. To do this, provide a full meal, with enough vitamin and mineral substances. Deficiency of certain vitamins and trace elements can reduce the protective function, which will trigger the spread of the viral infection.

What should be excluded from the diet:

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

It is recommended to eat dishes with a high content of vitamins, which contribute to the restoration of damaged tissue and strengthen immunity.

Folic acid is found in the following products:

• greenery;
• beans;
• citrus;
• bananas;
• cabbage;
• cereals (buckwheat and millet);
• walnuts.

Retinol (Vit. A) contains:

• in the liver;
• in butter and dairy products;
• in sea kale;
• in the fish.

Ascorbic acid can be found:

• in fruits of kiwi fruit;
• in Bulgarian pepper;
• in all kinds of cabbage;
• in citruses;
• in sorrel;
• in the radish;
• in currant berries, raspberries.

Tocopherol (Vit. E) is rich in:

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

When dysplasia is useful to eat foods with β-carotene:

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

Also the body needs selenium, which activates immunity and reduces the risk of oncological diseases:

• chicken eggs;
• beans;
• peanut;
• celery root;
• corn;
• rice cereals;
• 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 desirable to establish a drinking regime: you can drink pure non-carbonated water and green tea, rich in antioxidants.

Prevention

Specific prevention of dysplasia consists in carrying out vaccination against papillomaviruses type 16 and 18. It is these types of virus that are considered to be the most dangerous and can provoke the development of dysplasia and oncological diseases of the cervix. The maintenance of a special vaccine significantly reduces the risk of developing pathology.

Nonspecific prevention involves:

• observance of purity of sexual relations, prevention of venereal diseases;
• providing the body with folic acid;
• high-grade rational nutrition;
• periodic visits to the doctor, regular examination of the reproductive system.

In addition, it is not recommended to abuse tan. Also, do not inject into the vagina cavity any drugs or liquids not prescribed by the doctor.

Dysplasia of the cervix of the 2nd degree is mostly asymptomatic, which often becomes the reason for belated treatment of patients for medical help. For this reason, doctors recommend that you regularly visit a gynecologist for preventive purposes. This will allow to detect dangerous diseases in time.

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