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Cervical leukoplakia
Last reviewed: 23.04.2024
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Among the many gynecological pathologies, cervical uterine leukoplakia occupies a special position. Factors of the onset of this disease have not yet been fully clarified.
What is dangerous cervical leukoplakia? Why does this pathology arise and how can I get rid of it? We'll talk about this and many other things in this article.
Causes of the cervical leukoplakia
According to the scientific studies, the causes of leukoplakia can be quite a lot. These are previously present infections in the body, immunodeficiency disorders, hormonal disorders, unskilled cervical disease, trauma of the cervix during labor or with artificial abortion and other factors.
It is believed that the risk of getting leukoplakia in a woman with a menstrual cycle disorder or with an inflammatory pathology of the reproductive organs is several times higher than that of the rest.
The impetus for the development of the disease can serve as infection of the genital area, viral lesions (including herpes), promiscuous sex life. Risk factors also include various medical manipulations: diathermocoagulation of erosion, scraping, installation of a spiral contraceptive.
Symptoms of the cervical leukoplakia
Simple leukoplakia of the cervix does not have any characteristic symptoms: pathology is usually found on gynecological examination. However, some types of leukoplakia still have some signs, after discovering which, it is possible to suspect the development of the disease.
A healthy cervix has an epithelial covering, like all skin integuments. However, such a coating is not capable of cornification, so that the neck can stretch during labor. If the tissues are still keratinized, this is a pathology and is called leukoplakia.
Focal leukoplakia of the cervix is a pathology, in which appears a flat, located at the level of the mucous membrane, the lesion. Such a site can be found only during the colposcopy procedure. This is the most favorable form of leukoplakia, since structural disorders are observed only in the surface layer of tissues. The outbreak may appear in isolation, or be located in a group.
Extensive leukoplakia of the cervix can pass to other parts of the genitals: often this spread is observed on the vaults of the vagina. Extensive pathology is close to malignancy, it can be combined with cicatricial changes and cervical hypertrophy. This form of leukoplakia can be accompanied by severe itching (especially at night during sleep), pain and discomfort with sexual contact, the appearance on the skin of microcracks and a feeling of tightness.
Thin leukoplakia of the cervix is characterized by the appearance of the finest scales on the surface of the epithelium (peculiar thin films), which can be overlooked even during preventive examination. To diagnose this form of pathology, auxiliary laboratory tests may be required.
It is also possible to develop a warty form of the disease, which occurs as a consequence of simple leukoplakia. This complication manifests itself in the form of clear, flaky areas of keratinization, reminiscent of the appearance of warts.
Cervical leukoplakia and pregnancy
Leukoplakia, found during pregnancy, does not directly affect the process of gestation, the development of the embryo and does not provoke the formation of pathologies in the fetus. However, some danger still exists for the woman herself: the disease can worsen, causing the development of more complex conditions, including degeneration into a malignant process. This is facilitated by a decrease in immunity, a change in the balance of hormones during pregnancy, as well as labor, in which the tissues of the cervix are subjected to serious mechanical effects, stretching and damaging.
Undoubtedly, if leukoplakia of the cervix was found before pregnancy or in the planning process, it is necessary to get rid of the disease before the pregnancy, although pathology does not influence the process of conception itself. Before carrying out IVF, leukoplakia is preliminarily subjected to treatment without fail.
If the disease is not treated, the consequences of leukoplakia of the cervix can be serious: first of all, the appearance of atypical cells, which is the beginning of malignancy of the process.
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Diagnostics of the cervical leukoplakia
Complex diagnosis of cervical leukoplakia may consist of a clinical, cytological and colposcopic examination. On an individual basis, a doctor can prescribe morphological, bacteriological and bacterioscopic analysis. The most revealing are the studies of morphology and colposcopy.
The method of colposcopy provides an opportunity to assess the nature and magnitude of the lesion, to examine the general condition of epithelial tissues in the vagina and cervix of the uterus. The colposcope is the same microscope, but with a more significant increase, capable of viewing the smallest changes in the structure of tissues.
During colposcopy, it is possible to perform a so-called Schiller test - a painless test that can help in the proper diagnosis. The essence of the method consists in staining the surface of the cervix with 3% of Lugol's formula (the solution consists of potassium iodide, pure iodine and distilled water). This method allows to determine the absence of glycogen in the integument epithelium, which indicates atypical and non-conforming areas of epithelial tissues. As a result of coloring, the healthy tissue becomes brownish-dark, and the affected areas of its color do not change.
Early diagnosis of the disease can be carried out on the basis of special swabs with cervical epithelial tissue.
Analysis for cytology is taken with a special spatula or brush. At the same time, swabs are removed from the area of the cervix, located closer to the vagina, as well as from the lower part of the cervical canal. In the flat form of leukoplakia, keratin, a group of cells of the superficial epithelium, and a large number of discaratocytes are found in such assays.
Cervical biopsy with leukoplakia involves the removal of a sample of the superficial epithelium from the lesion site, followed by cytological and histological examination. Simultaneously, one can assess the scale of pathology, check the presence of degeneration and malignant tissue. In the case where the histological analysis confirms the dysplasia of the surface cover, the disease can be diagnosed as a precancerous stage of the process. The biopsy procedure is performed under local anesthesia with the aid of an electrocoagulation system.
Recently, for a thorough examination of the cervical tissue and the cervical canal, the method of microcampohysteroscopy has been successfully used. This procedure is not very painful, it provides an opportunity to simultaneously assess the condition of the surface cover, determine the presence of atypical tissues and conduct a targeted biopsy.
Macroscopically, leukoplakia manifests itself in the form of white whitish plaques, of various shapes and sizes, located on the background of unchanged epithelial cover.
The cornification of the flat epithelium is a consequence of the increased functional activity of the epithelial cells, which is absent in the conditions of normal vital activity of the epithelium.
The histological picture with leukoplakia is characterized by:
- proliferation of cells of multilayered planar epithelium;
- uneven thickening due to a significant increase in the number of intermediate (subulate) cells);
- acanthose;
- incomplete keratinization;
- complete keratinization of the epithelium (parakeratosis);
- lymphocytic infiltration of the stroma.
Background processes include leukoplakia without signs of atypism of epithelial cells.
Leukoplakia and papilloma form a special form of cervical disease - dyskeratosis.
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Differential diagnosis
When differentiating pathologies of the cervix, attention should be paid to the type of damaged tissue. It can be either epithelial tissue, or connective, or muscle. The presence of trophic and innervation disorders also plays a role.
Cervical dysplasia and leukoplakia are similar pathologies that do not have any characteristic clinical picture. The latent course of the process, the absence of pain and external signs of the disease pose a danger of further progression of pathology, as well as malignant cell degeneration. There is also a combined course of these diseases, which in any case requires complex therapeutic measures.
Leukoplakia and erosion of the cervix also have some similar signs. However, erosion is a defect, provoked most often by the action of chemical agents (detergents or drugs, aggressive substances), mechanical damage. With such a disease, the affected cervical region will be swollen and brightly hyperemic, with signs of bleeding. In addition, there may be complaints about the presence of minor bloody discharge, especially after intercourse.
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Treatment of the cervical leukoplakia
In modern times, many methods of treating leukoplakia of the cervix are offered. However, the best effect can be obtained only with an integrated approach to treatment, with the simultaneous application of several methods of therapeutic treatment. It can be medicamentous and laser therapy, cold treatment and diathermocoagulation and other methods.
In the case when leukoplakia is found against the background of inflammatory diseases of the internal genital organs, the first step is to eliminate the inflammatory reaction. For this purpose, antibiotics are prescribed (usually a wide range of effects), as well as indications of antitrichomonas, antifungal, antiviral and antichlamydia drugs, comparing the purpose of such drugs with the results of a bacterioscopy or tests for the presence of viruses and chlamydia.
It is not recommended to prescribe drugs that affect the metabolic processes in tissues and stimulate them. Such drugs (aloe, fibs, plasmin, sea buckthorn, rosehip) can enhance proliferation and promote the development of dysplasia.
Very popular and effective use of chemical coagulation. This method involves the use of such a drug as solkagin is a chemical compound of acids of organic and inorganic origin serving as a coagulant of a purely cylindrical epithelium that does not affect healthy tissues. This kind of therapy is painless and effectively destroys altered tissues. According to statistics, recovery of patients as a result of this treatment is about 75%.
Cauterization of cervical leukoplakia is used quite often, but this method has several negative side effects. This development of implantation endometriosis, the risk of bleeding in the rejection of coagulated tissues, the possibility of recurrence or exacerbation of the chronic inflammation of the ovaries, a disorder of the monthly cycle, a long healing period, the risk of repeated tissue damage.
As the most effective methods used at the present time in the fight against leukoplakia, you can call cryotherapy and laser method.
Cold treatment (cryotherapy) promotes necroticisation of affected tissues by exposure to low temperatures. The procedure is carried out contact, mostly once, for two to five minutes. The method is painless, the effect of such treatment is up to 95%. The only drawback of this method can be considered the possibility of a re-development of the disease, most often it affects patients with various disorders of menstrual function.
Laser treatment of cervical leukoplakia is a more modern and successfully applied method. The huge advantages of this procedure include contactlessness, painlessness, aseptic nature of such therapy. Laser treatment allows quickly and without the danger of bleeding to provide coagulation of damaged tissues, forming sufficient protection of the wound from the penetration of the bacterial flora. Usually laser treatment is carried out in ambulatory, without anesthesia, on the 5th-6th day of the menstrual cycle. Immediately before the procedure, the cervix is treated with Lugol's solution, which allows you to accurately determine the altered tissues that are subject to laser exposure.
If the prevalence of pathology is high, it is possible to designate laser therapy in several stages, with gradual coagulation of the affected areas. The final healing usually occurs within three to five weeks, which depends on the extent of the pathological lesion.
Removal of cervical leukoplakia is surgically performed at a late stage of the process, accompanied by hypertrophic and deformative changes in the cervix. The operation may include knife or laser conization, amputation of the cervix with further plastic surgery and organ reconstruction. This is a radical operation, which is used only in extreme cases.
Treatment with radio waves of cervical leukoplakia can be recommended for young nulliparous girls with a large-scale manifestation of the disease. This is a relatively new procedure that is conducted non-contact, radio waves, which play the role of a kind of scalpel. The essence of the method is as follows: a special electrode is injected into the cervical canal, which produces high-frequency discharges. Under the influence of these discharges, the tissues affected by pathology seem to evaporate due to the high temperature. The method is considered fairly sparing, recovery after treatment is relatively fast and painless.
Medical specialists strongly do not recommend the use of alternative remedies for cervical leukoplakia. Leukoplakia is a disease that can degenerate into a malignant pathology, and it is extremely unreasonable to delay with qualified treatment with such a diagnosis. Attempts to cure the disease on their own can not only harm, but also allow you to miss the time during which you could get rid of the pathology. In addition, the use of irritating tissues of infusions, the use of tampons and syringes, which are capable of causing mechanical damage to tissues, usually aggravate the situation and lead to complications of the disease. Leukoplakia of the cervix is not the case when the use of alternative methods is advisable.
During the entire treatment period and up to 45 days after it, sexual intercourse and the use of chemical contraceptives are not recommended.
Prevention
Preventive measures are primarily in the timely treatment of inflammatory diseases of the reproductive system, as well as disorders of the hormonal balance and the monthly cycle. Those women who, for some reason, had undergone diathermocoagulation or cryotherapy in the cervical region, should periodically visit a doctor for a colposcopic checkup.
Among preventive measures can be called a stable sex life, the use of contraceptive methods for unwillingness to become pregnant, as well as a periodic visit to the doctor for a medical examination.
With a tendency to inflammatory pathologies of reproductive organs, the following rules should be observed:
- avoid stressful situations, hypothermia, overwork;
- follow the rules of personal hygiene;
- use high-quality underwear made from natural fabrics;
- Revise their diet, excluding alcohol, spicy dishes, pickles and sweets;
- Do not smoke.
Include in your diet more vitamins: it will support your immune system and prevent the disease from progressing.
Forecast
Provided that the doctor is referred to the doctor in time, the prognosis of the disease can be favorable. With the development of pregnancy after the recent treatment of leukoplakia, it is necessary to constantly monitor the condition of the cervix.
Leukoplakia of the cervix is a disease that is difficult to diagnose. However, the timely detection of pathology makes it possible to cure the disease without dangerous consequences for the life and health of a woman.