Cervical papilloma

Warty multiple growths on the walls of the cervix, provoked by the viral pathogen of papilloma, are called papilloma of the cervix. Such a virus can enter the genital tract after unprotected sexual contact with the source of infection. For this reason, it is generally accepted that this disease more often affects women who do not have a regular sexual partner.

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Causes cervical papillomas

Several possible reasons for the penetration of the papilloma virus into the body are described:

• sexual intercourse with a man who is a carrier of the papilloma virus. In this case, the method of sexual contact and even the presence of a condom do not matter at all, the main role is played by the fact of the virus entering the body. Thus, the virus can get to a woman even through a kiss;
• the virus can also be transmitted through everyday life, in public baths, solariums, swimming pools, saunas, or on the beach;
• the infection can affect a newborn baby during childbirth from an infected mother;
• a person's weak immunity, weakened by alcohol, smoking, frequent stress, and digestive disorders, creates a favorable background for the development and progression of the disease.

The cervical papilloma virus can live for some time in the external environment, so it is not recommended to use other people's toiletries, underwear and towels.

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Symptoms cervical papillomas

The disease often occurs without any characteristic symptoms, which makes it difficult to diagnose papilloma. A later stage of the disease may manifest itself with the following signs:

• burning sensation in the external genital area;
• enlargement of regional lymph nodes;
• the appearance of previously uncharacteristic discharge.

The clinical picture of papilloma largely depends on the type of pathogen. For example, a pointed condyloma usually indicates an acute stage of the infectious process. But a flat papilloma of the cervix is considered a sign of a chronic lesion that causes disruption of the structure of the upper epithelial layer. In addition, the infection may not manifest itself externally due to good immune protection of the body.

Visual manifestations of pathology may be noticeable during a gynecological examination. What can a doctor see?

• The appearance of warty elements on the cervix. Moreover, these elements may appear and disappear alternately. The color of the integumentary epithelium is not changed.
• Dysplasia areas are a condition close to oncology. Cervical cancer and the papilloma virus are very closely related concepts. Unfortunately, specialists can often detect the malignant stage of papilloma much later than would be necessary for successful treatment. This situation is due to the fact that a woman does not suspect the existing disease for a long time and does not consult a doctor. Complex pathology is detected only during a random preventive examination.
• Lumpiness of the epithelium of the cervix, which can be not only seen but also felt. This condition is a sign of the appearance of pointed condylomas, multiple or independent growths on the skin. Such condylomas usually appear during the period of exacerbation of viral pathology.
• Cervical papilloma and erosion can successfully coexist with each other. When erosion is present on the surface of the cervix, ideal conditions are created for the vital activity of a viral infection. The presence of two diseases at the same time - erosion and papilloma - increases the risk of the pathology turning into a cancerous tumor.

Cervical papilloma during pregnancy

A papilloma detected during pregnancy planning must be treated, since in addition to the risk of malignancy of the process, there is the fact of recurrence of condylomas during pregnancy, as well as the growth of formations, which can become an obstacle during childbirth.

If the infection with the papilloma virus occurs during pregnancy, it can become a threat of miscarriage. Experts are still arguing about whether the virus affects the fetus and causes the development of various defects. It is only known that the transmission of the virus from mother to embryo can be from 5 to 80%: science has not yet determined how this happens. The most likely is the ascending route from the cervix, or contact - during labor. The defeat of the baby by the papilloma virus can manifest itself in the form of papillomatous lesions of the respiratory system, signs of wart-like formations on the external genitalia of the child. In this case, it does not matter whether the child was born naturally or by cesarean section.

An interesting fact is that the papilloma virus, which was detected in a woman during pregnancy, disappears without a trace in most cases after childbirth. Visual signs of the disease decrease in size or disappear completely. The papilloma virus detected in a pregnant woman is usually not detected later, that is, the so-called spontaneous healing is observed.

If the virus was detected before pregnancy, the percentage of self-healing is significantly reduced.

Diagnostics cervical papillomas

The main diagnostic methods for determining the papilloma virus:

• gynecological examination of a woman;
• performing a colposcopy;
• taking a smear for cytological examination;
• histological analysis of tissues;
• PCR.

The visual signs of the disease are so characteristic that a simple gynecological examination can often be enough to make a diagnosis. If a woman has papillomas on her external genitals, the cervix is examined without fail, and even a urethroscopic diagnostic method may be used.

The method of colposcopy and biopsy can be used in case of dysplastic changes of the cervix. In such cases, it is possible to conduct a test using acetic acid. The essence of this method is as follows: the cervix is exposed in mirrors, treated with acetic acid and iodinated Lugol's solution. If the papilloma virus is present, the treated area looks unevenly colored, as if in the form of a mosaic.

Cytological examination of the smear is carried out according to the Papanicolaou method (Pap test). The results of this method are divided into five classes:

• Class I and II mean the absence of damaged tissue structure;
• Class III requires additional histological examination;
• Class IV and V confirm the detection of atypical cells, a characteristic sign of a malignant process.

Histological examination also provides an idea of the possibility of malignancy of the pathology.

Macroscopically, papilloma of the cervix is defined as warty growths of a pink or whitish color, shaped like rosettes.

The histological structure of cervical papilloma is determined by the peculiarities of its development: papilloma is formed as a result of rapid focal proliferation of squamous epithelium; in this case, the superficial layers of the epithelium protrude above the mucous membrane in the form of a small fold, into which connective tissue and vessels grow, forming the basis of the papilloma "leg". In a number of observations, papillomas acquire a tendency to submersible growth, which can lead to malignancy of the background process.

The polymerase chain reaction method allows to determine the presence of the virus, as well as to find out and specify its type. The study also determines temporary viral forms capable of self-healing. This fact should be taken into account, and for this reason, a positive PCR should in no case be considered as confirmation of a malignant process. The test is recommended to be carried out for at least 15 types of papilloma virus (exactly the same number of virus types are capable of provoking the appearance of oncology).

If a diagnosis of papilloma against the background of dysplasia has already been established, PCR can help in identifying atypical cells.

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Differential diagnosis

Differential diagnosis should be carried out with the following diseases:

• squamous cell papilloma of the cervix is a benign formation of non-viral etiology, often appearing after mechanical trauma to the cervix, or as a consequence of the inflammatory process. By means of colposcopy, small smooth tumors with hyperkeratotic and parakeratotic changes can be seen. Such papillomas are removed surgically;
• leiomyoma is a small tumor of smooth muscle tissue, often observed against the background of other fibroids;
• endometriosis symptoms on the cervix - bluish-red and dark-colored spots are often confused with cystic formations. When examining such spots under a microscope, cells of the endometrium and endometrioid glands can be detected;
• erosive pathology – a violation of the integrity of the epithelial cover due to the irritating effect of chemical agents (detergents, douching liquids, etc.), or mechanical factors (use of tampons, intrauterine devices). In this case, the tissues of the cervix become loose, hyperemic, and bruises may be present.

An accurate diagnosis is often only possible with qualified comprehensive diagnostics.

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Treatment cervical papillomas

Due to the fact that the virus may behave inappropriately during treatment (both spontaneous healing and repeated relapse after therapy are possible), treatment is often directed not at the virus itself, but at combating papillomatous manifestations. The decision on the advisability of treatment is generally made by a specialist on an individual basis.

Treatment measures should be aimed, first of all, at increasing the body's defenses. Such measures include preventing hypothermia and stress, consuming the necessary amount of vitamins and microelements, an active lifestyle and adequate rest.

Among the main therapeutic methods for combating the papilloma virus, the following can be distinguished:

• destruction method – locally applied therapy, which implies removal of the affected areas using several methods: cold therapy, laser exposure, cauterization of papillomas on the cervix, excision using electrosurgery, use of chemical destruction (trichloroacetic acid preparations, solcoderm, feresol). Such methods can also be used during pregnancy, given the possible risk of bleeding and secondary infection.
• The use of cytotoxins (condyline, podophyllin, fluorouracil) is contraindicated for pregnant women, but is quite effective in the fight against the papilloma virus.
• immunology method – involves the use of interferons (special immune proteins). Such drugs include viferon, kipferon, reaferon.
• use of special antiviral drugs (alpirazine, cidofovir, panavir).

Unfortunately, removal of papillomas on the cervix cannot guarantee complete elimination of the disease and the absence of further relapses. A woman can remain a passive carrier of a latent infection, which can become active at any time convenient for her. For this reason, after completion of treatment, it is necessary to take measures to prevent recurrence of the disease.

Prevention

It has been proven that even protected sexual contact with a condom does not reduce the risk of contracting the papilloma virus. Therefore, you should play it safe and visit a gynecologist for a preventive examination at least once a year.

Additional preventive measures:

• having a regular sexual partner, avoiding promiscuous sexual relations;
• It is recommended to start having sex at the age of 18, when the tissues of the cervix are already sufficiently mature, and the mucous membranes can independently determine the level of protection against infection;
• prevention of roughness in sex, artificial abortions, curettage;
• active lifestyle, strengthening the immune system;
• carrying out vaccinations.

Vaccination against cervical papilloma is carried out simultaneously against several of the most dangerous types of papilloma virus. The administered serum does not contain living organisms, so it cannot cause any harm to a person. It is important to understand that the vaccination is not used to treat an already existing disease, but only for prevention.

The vaccination can be prescribed to both women and men in order to prevent the following pathologies:

• malignant disease of the cervix;
• malignant lesions of the external genitalia, including male;
• pointed condyloma;
• precancerous pathologies.

Vaccination is carried out in three stages: the second vaccination can be done 1-2 months after the first, and the third - 2-4 months after the second vaccination. The effectiveness of the completed procedure is estimated at 95-100%.

Side effects of such a vaccination include some deterioration in general condition during the first few days after the injection, and redness at the injection site.

Vaccination is not performed on people who are prone to allergic reactions to any of the components of the drug, pregnant women, or in the acute course of any disease. After treatment of exacerbations, vaccination can be performed.

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Forecast

The prognosis for papilloma can be favorable only if the body is completely freed from the virus. The highest probability of complete recovery can be achieved only with a comprehensive approach to treatment - this is the use of methods of destruction and antiviral therapy. With monotonous or interrupted treatment, the risk of relapse increases significantly.

People often take sexually transmitted diseases lightly. And while infectious pathologies can be cured with properly selected antibiotics, fighting viral infections is somewhat more difficult: viruses are harder to detect, and they sometimes behave extremely unpredictably.

Cervical papilloma is one of such diseases, which in some cases is difficult to treat, but sometimes can heal on its own.

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