Cervical dysplasia of the third degree

Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is a potentially precancerous condition and is characterized by abnormal growth (dysplasia) of squamous epithelium on the surface of the cervix. Severe dysplasia, or grade 3 cervical dysplasia, covers more than 2/3 of the epithelium, and can include the entire thickness. This type of lesion is sometimes called cervical cancer in place.

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Epidemiology

Cervical dysplasia of grade 3 can develop at any age, but is most often diagnosed at the age of 25 to 35 years.

Causes of the cervical dysplasia of 3 degrees

To date, the causes of cervical dysplasia of grade 3 have not yet been fully investigated. Practice shows that practically all patients who were diagnosed with this diagnosis had a human papillomavirus (HPV) in their anamnesis. Many medical workers blame him for the appearance of atypical cells - provocateurs of various pathologies.

Provoke these pathological changes are capable of other diseases:

• Hereditary predisposition.
• Inflammatory process, taking place in the organs of the small pelvis.
• Sexually Transmitted Infections. For example, syphilis.
• Other infectious diseases. For example, genital warts and chronic cervicitis.
• Reducing the body's immune forces.
• Prolonged smoking and drinking alcohol.
• Imbalance of the hormonal background.
• Early onset of sexual activity. Physicians consider a high risk of dysplasia, if this occurred before the age of 18. The increased mechanical action and hormonal stimulation of the epithelium leads to disruptions in its development.
• Trauma, which could happen due to frequent childbirth, abortion, diagnostic curettage of the uterine fundus.
• Ignoring the rules of intimate hygiene.
• Do not be too smart in connections. The presence of more than one partner increases the risk of infection with a sexually transmitted virus.

The pathology considered in this article is referred to polyethological diseases. This fact suggests that a failure in the development of mitosis and ripening of cellular structures of the mucosa causes a number of provoking factors. And they must be taken into account when appointing a treatment protocol.

[2], [3]

Pathogenesis

The cervix is the lower extremity of the female genitalia, which consists of a passage connecting the vagina with the uterine cavity. The walls of the canal are cylindrical cells of the epidermis, lining the canal into one layer and saturated with mucous glands.

The mucosa itself consists of three layers represented by various cellular structures: the superficial epithelium, the intermediate layer and the basal layer.

Pathogenesis of the pathological process is to change the balance of the layers. As the analysis shows, surface and transitional epitheliocytes show a pathologically changed presence of mitotically active cells, which should not be present in healthy tissue.

As a result of the growth, the layer of epithelial cells increases, leading to the development of hyperplasia.

The pathogenesis of cervical dysplasia is covered by a violation of the normality of cellular mitosis. This is what provokes cell division where it should not be.

[4], [5], [6], [7]

Symptoms of the cervical dysplasia of 3 degrees

At earlier stages, the disease can be asymptomatic. It is for this reason that doctors recommend that women at least once a year undergo an examination of the gynecologist, and even more often.

But when the disease is indicated by the neglected character of the flow, it is very difficult to notice its signs. Symptoms of cervical dysplasia of the third degree are as follows:

• In the lower abdomen, the woman begins to feel discomfort in the form of the appearance of a pulling and / or aching pain symptomatology. Especially, this symptomatology intensifies during menstruation.
• There is itching and burning in the area of the primary sexual characteristics of a woman.
• Enhancement of pathological discharge: leucorrhoea may be both bloody and of another shade. At the same time, they can exhale a fetid smell.
• Increased pain during intercourse.

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First signs

As already mentioned above, at the early stage of the disease the woman may not feel any discomfort. In this case, the first signs of pathology may appear much later, at later stages. In most cases - it's uncomfortable sensations in the genital area and in the lower abdomen (pain, burning, itching and so on). This should be the reason to seek counseling and to see a doctor - a gynecologist.

[9], [10], [11]

Cervical dysplasia of 3rd degree and pregnancy

Although not often, there are cases when a woman diagnoses such an unpleasant diagnosis during pregnancy. After all, to be registered in the women's consultation, she needs to undergo a certain package of examinations. Cervical dysplasia of the third degree and pregnancy is certainly not a rule, but it is not an exception to the rule. Such situations happen in principle.

In this case, the obstetrician-gynecologist, who leads the pregnancy, appoints the future mother a second analysis and additional examinations. In this case, such a survey is a biopsy. Carrying out this research during pregnancy is quite dangerous due to the high risk of miscarriage, but in this situation the question is about health, and even life, the mother. A biopsy is prescribed to a pregnant woman only for essential medical conditions.

In most cases, doctors take a wait-and-see attitude, prescribing medical or surgical treatment after the birth. And against the background of development of the fetus, they prefer to keep the future woman in childbirth under constant control, periodically conducting a cytological examination, which allows observing the pathology in dynamics.

Complications and consequences

To assess the dangers of the disease in question, it is necessary to represent the consequences to which it can lead if the problem is ignored or insufficient treatment.

And the consequences are very unpleasant:

• The degeneration of uncharacteristic epithelium into tumor-like structures with further mutation into cancerous tumors.
• Further penetration. That is, progressive proliferation with the defeat of healthy cells.
• Gradual appearance of metastases.
• The effect of stealing. As research shows, the cancer cell is more active and has increased metabolic processes, which leads to the fact that mutated structures consume the nutrients of the body, limiting this to healthy cells.
• Intoxication of the body patient - poisoning with toxins - the products of vital activity of malignant tissues.

Dysplasia of the cervix of the third degree belongs to physicians to precancerous conditions. And if appropriate measures are not taken, the likelihood of its development into uterine cancer is very high.

[12], [13]

Complications

With timely diagnosis and modern methods of treatment, even the 3rd degree of the pathology in question is not a verdict for a woman.

But, nevertheless, even after the necessary therapy, the risk of complication does not disappear.

• If the treatment did not affect the integrity of the organ, there is a chance of the disease returning.
• There remains the risk of the appearance of atypical cells and the further development of cervical cancer or neighboring organs. This is the most terrible complication of this disease.
• Decreased immunity entails an attack on the body of an invasive infection, against which there is not always enough strength to resist.

[14], [15], [16]

Diagnostics of the cervical dysplasia of 3 degrees

Suspicion of the presence of pathology can sneak in at the time of the next visit of a female doctor - gynecologist or the woman herself with the appearance of uncomfortable symptoms in the field of her genitals. Diagnosis of cervical dysplasia of the third degree is carried out similarly and at earlier stages of the disease.

The main diagnostic method here is a cytological scraping, which is sent to a laboratory test (PAP test). If this analysis shows the presence of violations, the doctor is assigned a more extensive examination of a woman:

• A biopsy is performed, followed by a histological examination.
• A number of other laboratory tests. For example, an analysis of HPV - human papillomavirus.
• Colposcopy - examination of the sexual organs of a woman with the help of a special optical device of the colposcope. It allows to reveal precancerous and cancerous changes in tissues of reproductive organs. In the case of the third degree of pathology, a specialist can observe that all layers of the channel wall were changed.

[17], [18], [19]

Analyzes

The first thing that is prescribed by a patient with suspicion of the disease considered in this article is the tests performed in the laboratory.

• PAP test, or as it is called by medical personnel - a Pap smear. This analysis refers to cytological studies. Material for it is obtained in the form of a smear taken during the next gynecological examination. The sample is sent to the laboratory for examination under a microscope. When an abnormal cell is detected, a woman is given an additional examination.
• A biopsy is performed. When colposcopy with a special tool, a small sample of the cervical tissue is picked. It is this that is investigated in the laboratory at a high resolution of the microscope. The presence of dysplasia and the severity of its development are assessed.
• Research on human papillomavirus (HPV). Taken material (smear) is sent to the polymerase chain reaction (PCR). If the HPV is recognized, its type is set.
• Immunohistochemistry with oncomarkers. This analysis is not performed for all patients, but only for those who are suspected of grade 3 cervical dysplasia or cancer. Special substances called oncomarkers, in the presence of atypical cells, bind to cancerous tumors, giving a positive result of the analysis.

And as a mandatory woman gives:

• General and biochemical blood tests.
• General and biochemical analyzes of urine.
• Blood to determine blood type and Rh factor.
• Bacteriological and bacterioscopic studies of vaginal discharge for infection.
• Research on the level of hormones in the pituitary-gonadotropic system.

[20], [21]

Instrumental diagnostics

The most popular are:

• Colposcopy - examination of the female genitalia with the help of a colposcope - special medical equipment, which is a binocular equipped with a lighting device. This study allows identifying foci of lesions, differentiating benign and malignant neoplasms, analyzing the condition of the mucosa and the degree of its damage. A smear is taken to conduct a further biopsy.
• On the background of monitoring with the help of a colposcope, a biopsy is performed.
• If necessary, ultrasound.

Differential diagnosis

After passing the whole complex of examinations, differential diagnostics is carried out. It includes an analysis of the results of laboratory and instrumental studies, as well as anamnesis of the patient. On the basis of this, diseases that are similar in symptomatology, but not confirmed by studies, are cut off.

An analysis of the patient's anamnesis and the results of the survey makes it possible to diagnose not only the disease itself, but also the stage of destruction on which it is located. Indeed, it is on this basis that one can talk about adequate, effective treatment or preventive measures that can maintain the patient's body condition within the framework of remission.

The specialist should be able to assess the clinic of the disease. The main criterion in this is the staging of pathology. Mostly, if a woman already experiences a manifestation of pathological symptoms, therefore, the patient is diagnosed with a third stage of cervical dysplasia, and even cancer. After all, the pathology considered in this article is considered to be a precancerous condition of the organ.

Treatment of the cervical dysplasia of 3 degrees

After diagnosing and determining the severity of the disease, the attending physician proceeds to prescribe the necessary protocol of therapy. Treatment of dysplasia of the cervix of the third degree is mandatory. Otherwise, a bleak prospect awaits a woman: a mutation of cells into cancerous tumors, which will invariably lead to metastases and death.

Treatment of this disease is carried out jointly by several methods.

1. Therapeutic treatment:
   • The use of vaginal suppositories that have antiviral characteristics.
   • Douching with special disinfectant antiviral solutions and herbal infusions.
   • Tamponing.
   • Use of cauterizing ointments.
   • Oral administration of antiviral drugs: allokin alfa, amizone, epigen intima, lavomax, panavir, groprinosin, kagocel, isoprinosine, modunnal, amixin, protiflazid and others.
   • Immunostimulants: Imunoriks, polyoxidonium, pyrogenal, actinolysate, immunal, glutoxim, viferon, deoxynate, geneferon, stemokin, gepon, copaxone-teva and other interferon preparations.
2. Surgery.
   • Electrocoagulation is the cauterization of a pathologically altered zone by means of an electric current.
   • Laser conization - removal of the problem with the help of special medical equipment that emits laser beams.
   • Removal of the dysplastic region by radio waves with the participation of a special apparatus of the sargitron. The essence of the methodology is similar to the previous one, but the radio wave of a certain frequency is used as a tool for influencing the problem zone.
   • Cryodestruction is the use of low temperatures, namely liquid nitrogen, to remove pathologically altered zones.
   • Ultrasonic destruction. The method of treatment is similar to the previous ones, only ultrasound is used instead of the laser and radio waves.
   • Classical surgical treatment with a scalpel.
   • Removal of the cervix.
3. Methods of Alternative Medicine:
   • Homeopathy.
   • Herbal treatment.

More details about the treatment of cervical dysplasia of the 3rd degree can be read here.

It is worthwhile immediately warning that an independent relief of the problem under consideration is unacceptable. Treatment of cervical dysplasia of the third degree should be prescribed only by an experienced specialist and be conducted under his supervision and control. Otherwise, only time will be lost to solve this problem, which in such a clinical picture is unacceptable.

Conization of the cervix with grade 3 dysplasia

Until recently, this method of treatment was almost the only way to get rid of pathology. Conization of the cervix with grade 3 dysplasia is the excision of altered tissues of the mucous organs of the reproductive system of a woman using classical methods of surgical treatment with a scalpel, a special surgical loop through which an electric current is passed, or a laser.

Conization of the cervix is the most traumatic method of treatment, since adjacent healthy cells are also excised along with the affected tissues. On the site of the operation, a coarse colloidal scar is formed. Intervention is under the influence of anesthesia, within the walls of the hospital.

[22], [23], [24], [25]

Medications

One of the methods of treatment of the considered disease is drug therapy. Medicines that are prescribed for cervical dysplasia of the third degree are antiviral drugs and immunostimulants. If a classical operation was performed, antibiotic therapy is mandatory in the treatment protocol.

In the role of antiviral therapy may be prescribed: amixin, allokin alpha, kagocel, amyzon, epigen intima, panavir, lavomax, isoprinosine, groprinosin, modulunal, protiflazid and others.

The immunostimulating drug isoprinosine is taken orally after a meal, with a sufficient amount of liquid. The starting dosage is assigned to two tablets three times throughout the day. The duration of the treatment course is ten days. Then a break in two weeks and so two or three treatment courses are conducted.

Contraindication of isoprinosine is the presence of a patient with a history of urolithiasis, heart rhythm problems, gout, chronic stage of renal dysfunction, as well as with increased sensitivity to the components of the drug.

The following immunostimulants are used: imunorix, polyoxidonium, pyrogenal, actinolysate, immunal, glutoxim, viferon, deoxynate, geneferon, stemokin, gepon, copaxone-teva and other interferon preparations.

Activating the immune forces of the body called polyoxidonium, which is used both in the role of injections, and in the form of vaginal suppositories.

Injections of polyoxidonium are carried out in the muscle or intravenously. The solution for the injection is prepared immediately before the injection. The solution is not subject to storage.

With muscle injection, 6 mg of the drug is diluted with 1.5 - 2 ml of distilled water for injection or saline.

When dripping intravenously, 6 mg of the drug is diluted with 2 ml of a 5% solution of dextrose, rheopolyglucin, hemodeza-H or saline.

The duration of therapy is determined by the attending physician individually, depending on the disease and the stage of the lesion. Suppositories of the drug are placed in the vagina. The therapeutic dosage in this case is 12 mg of active ingredient. For preventive purposes this drug is used in a dosage of 6 mg.

Suppositories are applied once a day, are administered before going to bed. The duration of therapy is determined by the attending physician individually, depending on the disease and the stage of the lesion. Contraindication to taking polyoxidonium is pregnancy and lactation, as well as individual intolerance or hypersensitivity to the drug.

In the role of antibiotics suitable: penicillin, moxicraft, quinolone, metronidazole, cefoperazone, lincomycin, tetracycline, vancomycin, ceftazidime, erythromycin, cefroxitin, latamoxen, cefotaxime and others.

Metronidazole is taken by the postoperative patient, both in the form of injections, and so and tablets orally.

The dose of the drug is individually prescribed in the range from 250 to 500 mg twice a day. Duration of treatment is about ten days. But this fact, as well as the dosage, is appointed and corrected, if necessary, by the attending physician.

Alternative treatment

It should be clearly remembered that alternative treatment of dysplasia is permissible only for mild forms of pathology. Cervical dysplasia of the third degree does not stop with such techniques.

[26], [27], [28], [29], [30]

Herbal Treatment

As already mentioned above, the disease considered in this article, which is on a precancerous stage, is not treated by any alternative means. Including not carried out and herbal treatment.

Use medicinal herbs can only be an auxiliary supportive therapy and then with the permission of the attending physician.

Here are some recipes for such a drug, which will increase the woman's immunity or allow you to quickly get rid of inflammation, or to sanitize the body.

• You can use vaginal tampons, moistened with aloe juice. It should be noted that the leaflets from which the juice was obtained must be at least three years old. Leaves to wash, grind, squeeze out juice. From bandage make a tourniquet. Dampen it in plant juice and insert into the vagina. Enter should be so that the outside of the left part of the bundle. This will make it easy to extract. The tourniquet should lie so that the medicine touches the cervix. The duration of therapy is about a month. Tamponing is performed a couple of times a day and is maintained for four to five hours.
• A similar tamponing can be done, but with the use of sea buckthorn oil instead. The duration of therapy is two to three months.

• You can make a collection by taking the flowers of the twig - two teaspoons, sweet clover - one teaspoon, yarrow - two teaspoons, dogrose berries - three teaspoons, calendula flowers - four teaspoons, nettle - three teaspoons. All the ingredients are ground and mixed. Take one teaspoon of the mixture and place in 200 - 250 ml of boiling water. Insist half an hour. To strain. The resulting liquid should be douched twice a day for one month. A tamponization with this solution will do. In this case, both in the first and second cases, the liquid must be warm.
• You can also use medicinal tea prepared on the basis of collection, taking: burdock root - one teaspoon, vitex - two teaspoons, astragalus - one teaspoon, meadow clover - one teaspoon. All the ingredients are crushed and mixed, the bay is liter of freshly boiled water. Put on the fire and bring to a boil, keeping it on the stove, five minutes. Let it brew for a third of an hour. To strain. The received liquid is taken orally (inside) two to three times during the day before a meal.

Homeopathy

To date, homeopathy is gaining increasing popularity among people who adhere to the treatment of various diseases using alternative medicine methods.

But this does not apply to the disease, which we consider in this article. Modern nontraditional medicine, to which homeopathy concerns, can not offer adequate effective treatment of cervical dysplasia of the third degree.

Operative treatment

How regrettable it sounds, but modern oncology today has almost the only method of treating cervical dysplasia of the third degree - surgical treatment. There is simply no other way to stop the problem. Only in case, for any reason, surgical intervention is unacceptable, the patient is prescribed medication, including in the protocol chemotherapy drugs, which can slow the development of the pathological process. But this does not give a full guarantee that further degeneration into cancerous tumors will not occur.

Operative therapy involves the removal of altered tissues. At the same time modern medicine is equipped with several such techniques:

• This is excision of the affected layers by surgical intervention. It is carried out in the case of a deeper location of the neoplasm. This is the way to completely get rid of the tumor. But the operation is quite traumatic, causing more damage to the body than other methods. To excision resorted in the event that other methods are not very effective. But modern medicine is ready to offer less traumatic ways to get rid of cervical dysplasia.
• Cryodestruction is a method of layer-by-layer burning of diseased tissues using liquid nitrogen, which has a very low temperature. The technique is also called "cold cauterization". This procedure is gentle, after it is carried out on the body of a woman, there is practically no colloid scars.
• Laser coagulation is a technique similar to cryodestruction, with the only difference being that instead of liquid nitrogen, the laser beam is the object of action on the tissue. As in the previous case, after laser coagulation scar tissue is not observed.
• Electrocoagulation is one of the oldest (after bandpass) methods of burning out. In this case, the electric arc becomes the object of action. Cauterization by this method can be carried out and sufficiently deep layers. The procedure is painful and very traumatic.
• Radio wave moxibustion. The burning procedure is carried out by means of high-frequency radiological waves. Scars on the body does not remain. It is possible to achieve "evaporation" of problem areas without the risk of hitting healthy fragments of the epithelium. The operation is painless and is carried out quickly enough.
• Application of a gamma knife or a cyber knife. The essence of the method in the possibility of radiation, supplied by a medical device, is to seal the blood vessels that feed the angioma. This makes it possible to block the feeding of the new growth, which leads to its withering away.
• Conization of the cervix. This is the most traumatic method of treatment, since along with the affected tissues, neighboring healthy cells are also excised. On the site of the operation, a coarse colloidal scar is formed. Intervention is under the influence of anesthesia, within the walls of the hospital. Until recently, this method of treatment was almost the only way to get rid of pathology.
• Amputation of the cervix. Surgical intervention is performed only under general anesthesia. But even today the complete removal of the cervix, and often other organs of the reproductive system of a woman, with the diagnosis of dysplasia of the cervix of the third degree is the only way to save a woman's life and reduce the risk of further mutations, avoid the defeat of nearby organs and lymph nodes. After this radical excision a woman, for some time, will have to reconsider her way of life: to give up sexual intercourse for at least one and a half to two months, reduce the level of physical exertion, give up hot baths, using only a shower (six to seven weeks).

Women who have undergone one of these surgeries should be observed by a gynecologist within the next five years, cytological examination of the smear every three months, and also on a colposcope.

Over time, if there were no relapses, the smear is dealt with every six months, and the colposcope - once a couple of years. This allows the specialist to observe postoperative dynamics, and when returning the disease, identify it at an early stage.

More details about the treatment of cervical dysplasia of the third degree read in this article.

Prevention

The essence of the recommendations for preventing the development of the disease in minimizing all factors that can become catalysts of pathology. As practice shows, it is not possible to significantly influence this process, but it is quite possible to take measures that at least partially reduce the risk of the appearance of the considered disease.

That is why the prevention of cervical dysplasia of the third degree is reduced to a number of such recommendations:

• Obligatory observance of all rules of hygiene of the whole body. And including the sex organs.
• Vaccination against highly-oncogenic infections, such as, for example, human papillomavirus and others (HPV). The best time for it is the beginning of sexual activity. The upper age limit is 26-30 years.

• In case of infectious disease, it is necessary to carry out the treatment prescribed by the specialist, in time and to the full recovery. This same, even more so, applies to infections that affect the genital tract of a woman.
• Lead a healthy lifestyle. No smoking, drugs and alcohol.
• A woman should have one sexual partner. This will reduce the risk of "catching" a sexually transmitted infection. Exclusion of casual sex.
• To apply barrier methods of contraception, having preliminary consulted with the gynecologist.
• If there is a malaise or even a slight discomfort in the genital area, consult your doctor immediately (obstetrician-gynecologist) for advice. Early diagnosis and adequate therapy of any disease is a pledge of recovery.
• Rejection of bad habits.

[31], [32], [33],

Forecast

Cervical dysplasia of the third degree is, although a precancerous, but not a cancer, although the risk of degeneration is high enough. If the disease was recognized on time and all the necessary therapeutic and surgical measures were taken, the prognosis of the disease considered in this article can be uniquely favorable.

A woman who has undergone such treatment can quite well live to a very old age.

If no qualitative treatment has been carried out, the risk of transformation of the affected cells into cancerous tumors is great, which, if the process is ignored, may well lead to a fatal outcome.

The cervix, like the uterus itself, is the primary sexual characteristics of a woman, and their defeat or loss is not only a physiological, but also a psychological problem for a woman. But in such a situation, the right priorities should be set. After all, the question here is about life or death. Help in this issue, except gynecologist - an oncologist will be able to another female psychologist. He will help the patient to properly assess the situation and decide on radical measures to get rid of the problem. After all, dysplasia of the cervix of the third degree, if not treated in time, can lead to an even more terrible and serious disease, like cancerous lesions of the cervix with further metastasis. Let every woman never lose the very desire to be healthy. It's worth fighting for!

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