How to treat cervical dysplasia?
Painless treatment of cervical dysplasia can be performed by cryodestruction. For manipulation there is no need to be hospitalized in the hospital, it can be carried out on an outpatient basis. Synonyms of cryodestruction are cryoablation, cryotherapy.
Features of the procedure
Manipulation involves the destruction of pathologically changed tissues by various cooling substances. Can be used:
- liquid nitrogen, temperature -196 ° C;
- carbon dioxide, has an effect at -78.5 ° C;
- nitrous oxide, temperature -85 ° C.
The most commonly used liquid nitrogen, which is directed to the pathologically altered area of the neck under a certain pressure. More information about these nuances can be found here: https://mioma911.ru/shejka-matki/eroziya/kriodestrukciya-shejki-matki.html
The tissue undergoes necrosis to a depth that does not exceed 5 mm; lateral frost penetration from the tip of the cryodestructor is 2-3 mm. To a greater depth of freezing does not occur. The cells cool, but remain viable. Therefore, treatment is carried out only for superficial pathological processes.
In what cases is cryodestruction necessary or contraindicated?
The main indication for cryodestruction is cervical dysplasia of 1 degree (CIN I). In rare cases, with a small size of the focus of dysplasia in the degree of CIN II, manipulation is also possible.In pathologies of another type, cryotherapy is not applied due to changes affecting the greater thickness of the tissues.
Do not carry out treatment in the following conditions:
- cervical cancer, histologically confirmed;
- lactation or lactational amenorrhea;
- premenstrual syndrome;
- lesion size greater than 3 cm;
- pathological focus extends to the cervical canal;
- neck rupture or deformity;
- exophytes, papillomas or nodules on the surface of the cervix;
During menstruation, cryotherapy is conditionally safe: the probability of pregnancy is completely eliminated. But because of the resulting neck edema, a violation of the outflow of menstrual blood may occur.
Any changes in the surface of the cervix, which violate its anatomical shape, will interfere with the normal procedure, disrupt the contact of the tip with the tissues. Therefore, a full deep freeze will not occur.
Preparation and technique of operation
The operation is carried out in the conditions of female consultation. The optimal period - immediately after the end of menstruation. To confirm the absence of pregnancy, it is recommended to conduct a rapid test on the day of the procedure.In the second phase of the treatment cycle is undesirable.
The procedure does not require special preparation (before the appointment of cryodestruction, the woman has already passed the necessary examinations, which confirmed the diagnosis, which is an indication for surgery).
The doctor warns about possible pains in the lower abdomen after cryotherapy, the appearance of discharge from the genital tract. An hour before the manipulation, you can take a pill for a non-steroidal anti-inflammatory agent (Analgin, Nimesulide, Ketorolac).
The operation takes place in stages:
- The neck is treated with a solution of Lugol with glycerin to more clearly see the lesions.
- A warm tip is pressed against the neck to completely close the affected area. If a protrusion of more than 3-5 mm is formed outside the tool, the center will not be completely removed.
- Start the circulation of nitrogen or other substances used. The tip at this time is frozen to the neck.
- The exposure lasts 3-5 minutes.
- After completion of exposure, wait for the tip to thaw. To accelerate the neck irrigated with warm isotonic solution.
Repeated freezing of tissues that did not fall into the zone of action is rarely used, but such cases are described in various studies.
To reduce the risk of complications of the procedure and the appearance of unpleasant symptoms, it is recommended to take painkillers (Analgin, Diclofenac, Ibuprofen) 3-5 days after it. Sex is prohibited within 4 weeks after cryodestruction.
Hydrorrhea - the appearance of watery discharge from the genital tract, is a normal manifestation of the healing process, there is 3-4 weeks.
Complications may occur during cryotherapy. Some women complain of weakness, fainting, bradycardia, or tonic-clonic convulsions may develop. Therefore, after the procedure it is recommended to maintain a horizontal position for several hours.
The pain in the lower abdomen worries for 1-2 days; to eliminate it, it is enough to take non-steroidal anti-inflammatory (as agreed with the doctor).
Rarely bleeding is rarely affected, but bleeding is not a characteristic complication of cryodestruction. Long-term effects in the form of cervical deformity or stenosis of the cervical canal are very rare. Inflammatory and infectious processes are isolated cases. Their reason is insufficient sanitation of the vagina before the procedure.
After cryodestruction dispensary observation is necessary. Control examination is carried out in 4-12 months.
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