Symptoms of cervical dysplasia

Cervical dysplasia is one of the most insidious gynecological pathologies that can provoke the development of cancer. Only timely diagnosis and properly selected treatment can prevent oncology and give the patient a chance for recovery. However, in advanced forms, the likelihood of developing uterine cancer increases significantly. It is necessary to distinguish between the concepts of "dysplasia" and "erosion", since the first option refers to structural disorders of the mucous membrane of the cervix, and the second - to violations of its integrity.

Symptoms of cervical dysplasia in most cases appear only at advanced stages. Women may experience vaginal bleeding, pain in the lower abdomen, including during sexual intercourse. To make an accurate diagnosis, it is necessary to undergo a gynecological examination using instrumental, laboratory and clinical research.

If we talk about the causes of dysplasia, the most common ones include:

• infection of the body with papillomavirus;
• smoking (increases the risk of developing the disease several times);
• improper diet and constant stress, leading to serious disruptions in the functioning of the reproductive system.

The very concept of "dysplasia" means structural changes in the mucous membrane of the cervix as a result of various destructive processes, which leads to a precancerous condition. The course of the disease is aggravated by viral diseases, as well as bacteria and microorganisms.

[ 1 ], [ 2 ], [ 3 ]

First signs

Symptoms of cervical dysplasia are usually scanty, so a woman may not suspect the presence of a serious pathology. Despite the different origins, dysplasia is always accompanied by changes in the epithelium at the cellular level. This disease does not have an independent clinical picture and is often disguised as other gynecological diseases (for example, erosions). Therefore, the pathology can be detected only during a preventive examination and with the help of additional studies (PAP analysis (SMEAR)). The initial form of the disease is almost asymptomatic.

The first signs of dysplasia are associated with the following manifestations:

• pain or discomfort in the lower abdomen;
• burning and itching in the genital area (especially worse during sexual intercourse);
• vaginal discharge mixed with blood;
• profuse leucorrhoea (usually milky white) without an unpleasant odor;
• contact bleeding (after sexual contact, gynecological examination or douching).

Often, symptoms of dysplasia appear when a secondary infection (cervicitis, colpitis) joins the pathological process.

To prevent the development of the disease, it is important to remember the need for regular examination by a gynecologist - at least 2 times a year. The choice of therapy methods will depend on the woman's age, the importance of preserving her reproductive system. If this pathology is not treated, the process will progress, and after some time, dysplasia will develop into stage III (severe), followed by the development of squamous cell carcinoma.

[ 4 ], [ 5 ]

Symptoms of cervical dysplasia grade 1

Symptoms of cervical dysplasia usually appear at the last (III) stage of the pathology development, when the entire epithelium of the mucous membrane of the cervix is affected. Unfortunately, at the initial stage the disease does not manifest itself in any way, and many women do not even suspect that they have a serious health problem.

Symptoms of grade 1 cervical dysplasia may appear against the background of inflammatory processes or gynecological infections. In this case, painful sensations in the lower abdomen, profuse leucorrhoea, and discomfort may be noted. The mild degree is characterized by damage to only 1/3 of the epithelium thickness. In this case, unexpressed changes in the structure of the epithelial cells of the basal layer are noted. Signs of damage by papillomavirus infection are koilocytosis and dyskeratosis.

With timely detection of dysplasia at the initial stage of development, in most cases (more than 70%) it is possible to achieve positive results in treatment. However, the therapy should be long-term (about 5 years), with constant monitoring and gynecological examination of the woman. Removal of HPV from the body in the vast majority of cases (57%) leads to complete recovery. According to statistics, only 1% of women with grade I dysplasia have the pathological process progress to more severe stages (CIN 2, CIN 3).

Symptoms of cervical dysplasia grade 2

Symptoms of moderate cervical dysplasia (CIN 2) are more pronounced, most often in the form of a nagging pain in the lower abdomen, painful sexual intercourse, profuse vaginal discharge (in some cases with blood streaks), itching and burning in the genital area (especially when infections are present). At this stage of the disease, more pronounced changes in the structure of epithelial cells are observed, with damage to half the thickness of the epithelial layer. The examination reveals a large number of altered cells (2/3 of the entire thickness of the mucous membrane of the cervix).

Symptoms of stage 2 cervical dysplasia indicate the danger of the disease, since untimely diagnosis and lack of treatment can lead to the transition to the last - third stage, followed by the development of cancer. According to various medical studies, approximately every 5th woman has stage 2 dysplasia progressing to stage 3. An important factor in effective treatment is the removal of the papillomavirus from the body, which gives a positive result in more than 40% of cases.

It should be noted that in modern medicine, instead of the usual term "dysplasia", the term "cervical intraepithelial neoplasia" is more often used, which indicates the formation of new cellular elements in the cervical epithelium that are not typical for this tissue. Treatment of CIN grades 2-3 involves the use of surgical methods: cauterization, cryodestruction (freezing), radio wave or laser treatment, excision (conization). Treatment tactics also include dynamic monitoring of the patient's condition for up to 2 years from the date of diagnosis, annual cytology tests, regular colposcopy, and correction of endocrine system disorders.

Symptoms of cervical dysplasia grade 3

Symptoms of severe cervical dysplasia are most intense due to pronounced structural changes (the appearance of pathological mitoses, huge hyperchromic cell nuclei). The altered cells occupy almost the entire thickness of the mucous membrane of the cervix. Only in half of the cases does grade 3 dysplasia disappear on its own; in other cases, it develops into cancer.

Symptoms of grade 3 cervical dysplasia include prolonged pulling pain in the lower abdomen, bloody vaginal discharge, profuse leucorrhoea (often with an unpleasant odor), pain in the genitals during sexual intercourse, gynecological examination, etc. In many cases, the pathology is accompanied by infections and inflammatory processes, which worsen the patient's condition and lead to an acute course of the disease. When grade 3 dysplasia is detected, the patient is prescribed surgical treatment, the method of which is selected depending on the severity, individual constitutional features, and the results of the patient's examination. Most often, this is cauterization or freezing (cryodestruction), as well as diathermocoagulation, laser therapy, conization, or scalpel amputation of the cervix. Thanks to these treatment methods, it is possible to preserve reproductive function, and only in particularly severe cases of the disease can extirpation be used, i.e. removal of the uterus.

Complications of cervical dysplasia

Symptoms of cervical dysplasia indicate pathological changes in the mucous membrane of the cervix at the cellular level. This may be a burning sensation, itching, stabbing or pulling pain in the lower abdomen. The percentage of risk of cervical cancer depends on the degree of dysplasia. Timely detection of the problem and the use of effective treatment methods at early stages reduces the risk of malignant tumors. The degree of dysplasia is determined based on the results of a histological examination.

Complications of cervical dysplasia after surgical treatment (cryodestruction, cauterization, laser excision, etc.) include the occurrence of aching pain in the lower abdomen, bleeding, profuse vaginal discharge, and a sharp increase in temperature. In such cases, the patient should immediately contact the attending physician.

More serious complications of surgical intervention include:

• cicatricial deformation of the cervix;
• menstrual cycle disorders;
• occurrence of relapses of the disease;
• exacerbation of inflammatory diseases of the female genital organs;
• infertility.

If the surgical manipulation is performed correctly by an experienced specialist, complications usually do not occur. The woman is recommended to abstain from sexual intercourse for 4-6 weeks, limit physical activity, refrain from using tampons, douching, taking baths, going to the bathhouse, swimming pool or sauna.

Contraindications to the use of surgical treatment methods are:

• presence of sexually transmitted infections;
• pregnancy;
• adenocarcinoma;
• inflammatory processes in female organs.

Pregnant women are prescribed colposcopy with targeted biopsy. Childbirth occurs spontaneously, cesarean section is resorted to only in case of obstetric indications.

Symptoms of cervical dysplasia completely disappear after successful treatment and no longer bother the woman if she followed all the doctor's recommendations. 2-3 months after treatment, a control colposcopy is performed, as well as a cytological examination of the smear. Timely detection of dysplasia and the use of effective treatment methods are the main measures for preventing malignant neoplasms.

[ 6 ], [ 7 ], [ 8 ], [ 9 ]