Leukoplakia of the cervix: causes, diagnosis and treatment

Authors of the article: Candidate of Medical Sciences O.Yu. Ermolaev

Experienced gynecologist, physiotherapist-resortologist E.K. Ermolaeva
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From patient reviews

Leukoplakia of the cervix is ​​a roughening of the mucous membrane of the vaginal part of the uterus.

Leukoplakia of the cervix belongs to the background diseases - diseases of the female genital area, against the background of which an oncological process can occur.

Leukoplakia of the cervix malignizes (“degenerates into cancer”), according to a number of authors, in 13-31% of cases.

• Symptoms of leukoplakia of the vulva, vagina and cervix
• Causes of leukoplakia
• Leukoplakia and pregnancy
• Diagnosis of cervical leukoplakia
• Treatment of cervical leukoplakia
• Reasonable restrictions for leukoplakia
• Cost of treatment of cervical leukoplakia WITHOUT PAIN

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What is leukoplakia

Leukoplakia of the cervix is ​​a pathological condition, which is presented in the form of keratinization and thickening of the upper layer of the epithelium of the cervix. The severity of epithelial thickening can vary: from hyperkeratosis and parakeratosis to acanthosis. When examined, leukoplakia of the cervical epithelium looks like whitish plaques that rise above the mucous membrane of the cervix, but if leukoplakia is in the cervical canal, it can only be diagnosed using colposcopy.

Cervical disease leukoplakia occurs in 5% of all cervical pathologies, and this number is women of reproductive age. Its danger is associated with a high degree of oncological alertness and malignant degeneration (according to statistics, every third woman diagnosed with leukoplakia and lack of treatment develops oncology).

Clinical manifestations

Treatment of leukoplakia of the vagina or uterus is prescribed depending on the manifestations and symptoms. Women with this pathology may complain of the following types of discomfort:

• insufficiency of vaginal secretion;
• pain in the lower abdomen;
• pain during urination;
• cracks on the labia;
• spots on the mucous membrane;
• warts;
• erosion;
• genital discharge;
• scales.

Often the lesions do not cause discomfort, remaining unnoticed by the patient. This is why regular visits to the gynecologist are necessary. You can find a doctor you can trust at the Dr.AkNer clinic. We employ the best specialists with extensive experience in the treatment of women's diseases.

Reasons for the development of the disease

Leukoplakia of the cervix: causes are divided into two groups:

In addition to the reasons that cause the development of leukoplakia, it is worth remembering about those background conditions that aggravate the course of the disease: HPV infection, chlamydia, mycoplasmosis, ureaplasmosis, CMV, HSV, cervicitis and colpitis. An important place is occupied by poor sexual hygiene and frequent changes of sexual partners.

Prevention and prognosis

In most cases, the prognosis is favorable. The absence of human papillomavirus infection and dysplasia indicates a low risk of malignant tissue degeneration. Surgical intervention not only eliminates the risk of organ malignancy, but also preserves reproductive function. After treatment, the gynecologist regularly conducts examinations to eliminate the risk of relapse.

Simple medical recommendations can reduce the likelihood of leukoplakia and other diseases of the reproductive system. Prevention methods are aimed at changing lifestyle and eliminating negative external factors.

Basic methods of prevention:

• use of hormonal drugs only under the supervision of a physician;
• regular gynecological examinations;
• keeping a calendar of the menstrual cycle and contacting a doctor if disorders occur;
• refusal of alcoholic beverages and cigarettes;
• timely treatment of chronic diseases of the genital and endocrine organs;
• using a latex condom;
• sexual intercourse only with a trusted partner (HPV infection can be transmitted even when using a condom).

A consultation with a gynecologist or oncologist will help a woman learn more about the risk factors for leukoplakia and treatment methods for this disease. If necessary, the doctor immediately conducts an examination and excludes the presence of suspicious changes in the cervix.

Forms of leukoplakia

Leukoplakia on the cervix is ​​divided into simple and proliferative.

A simple form of cervical leukoplakia is a background change - hyperkeratosis or parakeratosis, manifested by thickening of the surface layer of the epithelium and its keratinization. Unlike the proliferative form, here the basal and parabasal cells do not change in any way. Simple leukoplakia of the cervix, unlike the proliferative form, does not have impaired differentiation of all cell layers and atypical elements.

The proliferative form (precancer) is also called cervical intraepithelial dysplasia.

Now, knowing the forms of leukoplakia, everyone knows how leukoplakia differs from dysplasia.

Diagnostics

The diagnosis of cervical leukoplakia can be suspected when a doctor examines the cervix in a speculum. If white spots or plaques of oval shape and different sizes are detected on the surface of the neck, the boundaries of which are clear, it is worth conducting an additional examination to clarify and confirm the diagnosis.

The list of diagnostic measures and studies includes:

• Cytological analysis of scrapings from the cervix (groups of epithelial cells with hyperkeratosis or parakeratosis). Nuclear-free horny scales are characteristic of hyperkeratosis. But parakeratosis is distinguished by increased staining of the cytoplasm of cells in which a pyknotic nucleus is detected. The presence of hyper- or paraketosis in the organ prevents atypical cells and proliferation cells from entering the analysis, therefore this method is uninformative and unreliable
• Targeted biopsy of the cervix followed by histological examination of the tissue composition is a more reliable and informative method for making a diagnosis
• Diagnostic curettage of the cervical canal excludes or confirms cervical cancer
• Colposcopy not only reveals white plaques on the surface of the cervix and in the cervical canal, having a fine-grained surface, clear and smooth edges without signs of blood supply. The Schiller test, performed during extended colposcopy, allows one to judge the size and distribution of lesions (from single lesions to multiple). A white spot on the cervix during colposcopy is a sign of leukoplakia
• Smear examination
• HPV PCR and typing
• Hormonal study
• Immunological research.

Medicines

Photo: kak-bog.ru

In the presence of an infectious disease of bacterial etiology, antibiotics are prescribed, the action of which is aimed at destroying pathogenic microorganisms. As a rule, broad-spectrum antibacterial agents are used, since they are effective against both gram-negative and gram-positive microflora. While taking antibacterial agents, various undesirable effects may appear, but the most common side effects are from the gastrointestinal tract (nausea, vomiting, heartburn, diarrhea). As is known, taking antibacterial agents affects the quantitative composition of the normal microflora of the intestinal tract, which is why in some cases probiotics are additionally prescribed.

In case of herpes infection, acyclovir is prescribed. The dosage of the drug and the frequency of administration are determined by the attending physician, based on the severity of the process and the severity of clinical manifestations. While taking the drug, the following side effects may occur: periodic discomfort in the epigastric region, nausea, occasionally vomiting, increased stool frequency. It is also worth noting that while taking acyclovir, it is important to monitor creatinine and urea levels, since this drug is known to have a detrimental effect on kidney function. Accordingly, people suffering from chronic kidney disease are advised to refrain from using this drug or to more carefully monitor laboratory parameters to assess kidney function.

Antifungal drugs (fluconazole, ketoconazole, itraconazole) have a fungicidal or fungistatic effect and are used for the treatment and prevention of mycoses. The most common undesirable effects that occur while taking antifungal drugs are: periodic discomfort or pain in the abdomen, heartburn, a feeling of bitterness in the mouth, nausea, occasionally vomiting, flatulence, constipation, dry oral mucosa.

In the presence of an infectious-inflammatory disease of the reproductive system, non-steroidal anti-inflammatory drugs (ibuprofen, diclofenac) are prescribed. The mechanism of action is to inhibit the enzyme COX (cyclooxygenase), as a result of which the synthesis of prostaglandins is disrupted. Thanks to this mechanism of action, not only an anti-inflammatory effect is achieved, but also an antipyretic and analgesic effect. Non-steroidal anti-inflammatory drugs should be used with caution by people with gastrointestinal diseases, since long-term use of these drugs, especially in large doses, leads to damage to the mucous membrane of the digestive tract.

Treatment

Leukoplakia of the cervix: treatment depends on what form of the disease is simple or proliferative. The main goal of treatment is to eliminate underlying diseases and completely remove foci of the disease. In the complex of therapeutic measures for the treatment of leukoplakia, antibacterial therapy, antiviral drugs, as well as a course of anti-inflammatory treatment are prescribed individually.

The main focus is the removal of foci of leukoplakia. Today, in gynecological practice, cryodestruction is actively used for this purpose. radio wave method, argon plasma coagulation, as well as diathermocoagulation and coagulation by chemical means.

Treatment is carried out on an outpatient basis, and the healing process does not exceed 2 months (healing time depends on the extent of the cervical lesion, the depth of penetration, the presence of somatic pathology, as well as the method that the doctor used.

Doctors strongly recommend that she not be sexually active during treatment.

Conization of the cervix is ​​also one of the methods of treating leukoplakia, but provided that the woman is diagnosed with intraepithelial neoplasia, kraurosis, and scar changes. Unfortunately, the process can be so advanced that one has to resort to amputation of the cervix as a radical method of treatment.

It is easier to prevent a disease than to treat it. This statement is not simple and implies the implementation of certain rules at the stage of preventing the development of pathology. To prevent the development of cervical leukoplakia, doctors recommend regularly visiting an obstetrician-gynecologist and if erosion, inflammation or an infectious process in the pelvic organs is detected, as well as avoiding artificial termination of pregnancy, cervical injuries during operations on the pelvic organs and during childbirth, use barrier contraception, as well as prevention of sexually transmitted infections. Compliance with all this will increase the chance of non-occurrence of this pathology. A special place today is given to the prevention of HPV through vaccination.

Methodology

The decision on electrocoagulation is made immediately after plaque lesions are detected during a gynecological examination or colposcopy. During the examination, a tissue biopsy is necessarily taken for subsequent histological examination to confirm leukoplakia and exclude cancer. Before electrocoagulation, a woman undergoes all the necessary tests:

• gynecological smear;
• cytological smear-imprint;
• blood for biochemistry;
• blood for hormones;
• immunodiagnostics, etc.

The cauterization procedure itself is performed on an outpatient basis in the sterile conditions of a small operating room. The cervix is ​​exposed and treated with antiseptics. The electrode of the apparatus for electrocoagulation is applied to the pathological lesions. This device generates alternating currents. Under the influence of current energy, plaques are cauterized. The duration of cauterization is several minutes, and depends on the extent and stage of the process. In any case, it is important not to leave any area unattended and to cauterize all plaques.

The cauterization procedure is quite painful. Therefore, it is performed under local anesthesia. In emotional patients with increased pain sensitivity, it may be necessary to introduce a shallow anesthesia. Therefore, 2-4 hours before the intervention, eating and drinking is undesirable.

During the first hours after the intervention, the woman is under medical supervision. Then, if her condition is satisfactory, she is sent home. As a complement to surgical intervention, the doctor prescribes conservative treatment (anti-inflammatory, hormonal agents, immunostimulants, hormones, etc.).

After cauterization, a scab forms on the wound surface. This scab is sloughed off in about 12 days. And for complete healing of the wound it will take up to 2 months. All this time you need to refrain from intimacy, from visiting baths and saunas, as well as from using vaginal tampons.