Consequences and complications of cervical dysplasia

The consequences of cervical dysplasia are the characteristics of the course of the dysplastic process depending on its severity:

• I degree. Most cases of detected dysplasia are successfully treated, provided that the provoking factor is diagnosed in time. For example, the definition of HPV as the causative agent of pathological transformation of epithelial cells requires treatment. After 6-12 months after the therapeutic course, laboratory tests do not show the presence of the virus in principle. Only in 10% of women, treatment can last a little longer than a year. In 30% of observed cases, cervical dysplasia remains stable and does not progress to the second degree. Only in a small number of women, the initial form of CIN can progress and progress to the second degree. This cannot be considered a direct consequence of dysplasia itself, rather the cause is an infection, a virus. Identification of etiological factors dictates the further direction of all therapeutic measures.
• Stage II also cannot be a reason for diagnosing cancer. The consequences of detected stage II CIN can be alarming only in the absence of adequate treatment, or the woman's refusal of observation and therapy.

Statistics show the following figures:

1. 35-40% of women who have successfully treated HPV (or STIs) do not need frequent preventive examinations. Dysplasia goes away on its own with adequate treatment
2. 30% of cases show a stable course of dysplastic processes without transition to a more severe degree
3. In 75% of women, doctors note a complete recovery after 1.5-2 years, if complex therapy is carried out and the provoking factor is completely eliminated.
4. 10-15% of patients may fall into the risk category. Stage II CIN progresses to stage III

• Stage III CIN is a serious reason for long-term examination and treatment. The reason may be related to age-related changes in the woman's body, social factors (living conditions), previously undetected chronic diseases, including infectious, viral etiology. To prevent such consequences and the risk of developing oncology, women are recommended to undergo comprehensive gynecological diagnostics, including cytology, at least once a year.

The consequences of cervical dysplasia are mainly the symptoms of an advanced process. In other cases, when the disease is stopped at an early stage, its consequences are absent.

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Recurrence of cervical dysplasia

Cervical dysplasia may recur even after treatment. Recurrence of CIN is determined by the activity and type of the provoking factor, most often an infection or virus.

Even long-term therapy does not always guarantee complete healing, especially when it comes to the human papillomavirus (HPV). The virus can remain viable in epithelial cells for many years under the following factors:

• Immunodeficiency, including HIV.
• STDs are diseases that are transmitted sexually, which is not uncommon when diagnosing HPV itself.
• Antisocial lifestyle.
• Lack of vitamins, macronutrients, amino acids, poor nutrition.
• Concomitant chronic diseases in chronic form.
• Medications taken at the wrong time during a course of therapy.
• Failure to comply with hygiene regulations.
• Disruption of the hormonal system.
• Lack of diagnosis and treatment of the partner (secondary infection, relapses can occur infinitely often).

What can prevent recurrence of cervical dysplasia?

• Regular preventive examinations.
• Adequate therapy and competent choice of methods (destruction of the cervical area using a laser, conization or other options according to indications, immunomodulatory therapy, applications, suppositories, external procedures, etc.).
• Parallel examination and treatment of the partner.
• Compliance with all rules of specific hygiene.
• Complete nutrition with the inclusion of vitamin complexes, microelements, and fiber.
• Absence of stress factors that can also provoke a relapse.

The risk of relapse can be high, medium and extremely low. Let's consider in detail in which cases the return of the disease is possible and when it can be minimal.

1. High risk. This group includes about 40% of patients over 40-45 years old who have not received a full course of HPV treatment or who reject preventive examinations.

Often, relapse of cervical dysplasia occurs during the period of therapeutic measures as part of the treatment process (resistance to the virus and drug therapy). Relapse is typical for CIN of moderate and severe degree, as well as for a complex course of the disease in combination with immunodeficiency (HIV).

2. Average risk level. No more than 15% of women fall into this category, more often in cases of surgical intervention without proper antiviral prophylaxis afterwards. Complications are possible after an unsuccessful surgical procedure - incomplete excision, conization. Concomitant infections of the genital area (candida, trichomoniasis, all types of STIs) also affect the average risk level.
3. Low risk. Young patients under 35 with a history of cervical dysplasia of the first degree may be at minimal risk. Full adequate treatment and mandatory preventive measures to prevent the "return" of HPV significantly reduce the risk of relapse.

To sum up, we can talk about the following factors that reduce the likelihood of recurrence of CIN:

• Age (the younger the woman, the lower the risk).
• The state and activity of the immune system.
• Tactics of drug therapy and strategic planning of concomitant treatment (exercise therapy, vitamin therapy, diet).
• The presence or absence of chronic latent diseases and concomitant pathologies of infectious etiology.
• Preventive measures.

In conclusion, some statistics:

• Treatment without prevention – relapse in 35-40% of cases.
• Surgical treatment method – reduces the risk of recurrence to 15%.
• Complex treatment, including drug and surgical methods in combination with prevention - the risk of dysplasia returning tends to 2-3%.

Complications of cervical dysplasia

Cervical dysplasia of the first two degrees occurs without pain and practically without complications. The most dangerous consequences of CIN can be considered oncological processes, among which the leader is cervical cancer.

Complications occur in the following cases:

• Late detection of cervical dysplasia in the early stages.
• Lack of or failure to comply with all stages of complex treatment.
• A woman's unwillingness to undergo annual preventive examinations.
• Genetic predisposition to pathologies prone to malignancy (oncology).
• Menopause.
• Overlapping of several infectious diseases (a combination of STDs, immunodeficiency).

Cervical dysplasia has a large list of forms of the disease, but the most dangerous, threatening serious complications, is considered to be stage III CIN, in some cases leading to cervical cancer. The period of malignancy (transition to the malignant stage) can last for years (up to 10 years). Rapid transformation is also possible and is caused by secondary pathologies that accelerate the development of the oncological process. The first stages of disruption of the structure of epithelial cells pass without clinical manifestations, the symptoms are extremely weakly expressed. Atypical degeneration of the cellular structure can be determined only in several layers of the mucous membrane. When a woman independently notes unpleasant sensations, including pain, this may indicate the transition of dysplasia to an extreme degree. The body of the uterus, vagina, cervix are affected, atypia is noticeable in all layers of the epithelium, which is already clinically and laboratory determined as carcinoma in situ (in the initial stage). If metastases affect the lymphatic system, bone tissue, nearby organs, the complication manifests itself in severe pain and typical signs of the oncological process (cachexia, swelling, changes in body temperature, weakness).

In addition, complications of dysplasia may be a consequence of certain moments of the disease treatment. These include the following manifestations:

• After surgery, which is sometimes indicated as a method of treating dysplasia. Bloody discharge, temporary bleeding are considered normal phenomena, which are explained by a fairly large sector of the wound surface. After surgery, you should not use hygienic tampons, you need to limit sexual contact. This is perhaps one of the not very pleasant disadvantages of choosing an operation using surgical instruments.
• Even if dysplasia was treated with a more modern method, radio waves, in any case, scar tissue forms on the uterine mucosa. Scars change the elasticity and ability to stretch the tissue for the worse, this can complicate childbirth somewhat (risk of ruptures in the cervical canal).
• The ability of some types of dysplasia to relapse can also be considered a complication. This is most often associated with the activity of the papillomavirus, which is the leader in the list of factors that provoke CIN.
• Dysplastic localizations can be removed by any method, but there is always a risk of reducing local tissue immunity. As a consequence, there is a risk of infections of various etiologies. Complications of cervical dysplasia can be prevented by strictly following all the recommendations of the gynecologist, personal hygiene, and contraception for 1-2 months after surgery.

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