Leukoplakia of the cervix is a change in the state of its external pharynx, characterized by the appearance of a whitish plaque. There is no unanimous opinion on its essence in medicine yet. Some believe that this is a polyethological disease (which can be provoked by various reasons). Others believe that leukoplakia cannot be called a disease — it is only a change in the appearance of the uterus, indicating this or that deviation in the body.
The content of the article:
Forms of cervical leukoplakia
Causes of cervical leukoplakia
Symptoms of cervical leukoplakia
Diagnosis of cervical leukoplakia
Treatment of cervical leukoplakia
Prognosis for cervical leukoplakia
Prevention of cervical leukoplakia
Cervical leukoplakia
As a rule, against the background of some gynecological disorders, tissue proliferation and keratinization of the multilayer epithelium occur. This phenomenon is localized in the cervix, less often in the cervical canal. During diagnosis, plaques are found that slightly rise above the mucous membrane.
Forms of cervical leukoplakia
There are two main forms of this pathology:
simple cervical leukoplakia;
proliferative (polyreferent with cell atypia) leukoplakia of the cervix.
In the first case, we are talking about a background change in the state of the cervix, which is considered benign and does not entail serious consequences with adequate treatment. In the second case, atypical structural cellular elements appear, which gives reason to characterize the patient’s condition as precancerous.
Simple leukoplakia can be characterized as an easily exfoliated white thin film. After removing the keratin layer, the affected areas of a brilliant pinkish hue appear. It is based on them that an objective conclusion can be made about the extent of pathology. Simple leukoplakia does not have vessels.
According to studies, approximately 31.6 percent of patients with cervical leukoplakia have a multilayer squamous epithelium undergoing a malignant transformation.
It is also possible to classify leukoplakia by visibility with the naked eye:
clinically pronounced form — detected during a routine examination;
colposcopic form — can be determined only with the help of the Schiller test (“mute iodine negative zones”).
Simple leukoplakia is most often clinically pronounced.
Accordingly, the problem of how to treat cervical leukoplakia will be solved depending on the identified form.
Causes of cervical leukoplakia
According to research, a little more than five percent in the structure of all diseases or abnormalities of the cervix are occupied by leukoplakia. The main reasons for their occurrence are gynecologists call:
cervical injuries (abortion, birth trauma, coagulation of erosion);
hormonal homeostasis;
infectious diseases;
illiterate treatment of cervical pathologies or its absence;
disorders in the immune system.
In addition, the appearance of leukoplakia can provoke:
inflammatory processes (adnexitis, endometritis, colpitis, cervicitis);
menstrual cycle disorders (amenorrhea, oligomenorrhea);
ectopia of the cervix (abnormal location of the cylindrical epithelium that lines the cervical canal from the inside);
reduced ability of the body to respond to external stimuli;
promiscuous sexual relations.
Less often, a non-standard whitish color of the surface of the cervix may be a physiological feature of a woman.
Symptoms of cervical leukoplakia
In most cases, this phenomenon is asymptomatic. It is possible to detect the presence of leukoplakia only in the process of gynecological examination. The reason for contacting a specialist can sometimes be whites with a specific smell, itching in the genital area or blood discharge (usually after sexual intercourse).
But even a gynecologist does not always see leukoplakia — depending on whether he is dealing with a clinically pronounced form of pathology or colposcopic.
Diagnosis of cervical leukoplakia
As already mentioned, simple leukoplakia is detected during the examination by a gynecologist. Its foci, in most cases, rise above the unaffected part of the epithelium. Plaques have a well-defined shape, and their sizes can be different. If they are detected, it is worth conducting a colposcopy and biopsy, which will more accurately determine the nature of leukoplakia. Also, for completeness of diagnosis, the doctor prescribes curettage of the mucous membrane of the cervical canal.
In the course of the study , the following morphological changes can be identified:
acquisition by the epithelium of the superficial stratum corneum;
thickening of the integumentary epithelium;
the appearance of a granular layer of epithelium consisting of specific cells whose cytoplasm is distinguished by the presence of basophilic granules;
lymphoid impregnation of connective tissue located under the epithelium.
Cytological examination in case of detection of leukoplakia is ineffective, since the doctor is interested in the processes occurring in the deep basal layers. Therefore, preference is given to biopsy.
Treatment of cervical leukoplakia
There are several methods available today, but they are united by a common goal — the removal of foci of leukoplakia. The most common methods of treating cervical leukoplakia are:
argon plasma coagulation;
coagulation with solkovagin (a chemical coagulant recommended for women who have not given birth);
diathermocoagulation;
radio wave destruction;
CO2 laser vaporization;
cryogenic effect on foci.
If, at the time of detection of leukoplakia, the patient suffers from an inflammatory or viral disease, then it is treated first. Thus, one of the following types of therapy may be prescribed first:
antibacterial;
antivirus;
antifungal;
anti – chlamydia;
antitrichomonas.
The effectiveness of leukoplakia treatment is about 47.5 percent.
Despite the fact that the treatment of leukoplakia plaques involves their removal, cervical leukoplakia should be eliminated extremely delicately, without disruption of tissue metabolism. Appropriate drugs can activate proliferative processes, which, in turn, leads to cervical dysplasia.
CO2 laser and cryotherapy, according to scientists, are the most effective methods of treating cervical leukoplakia. They have a lot of advantages compared to others.
Advantages of CO2 laser treatment:
painlessness;
contactless;
no risk of infection;
bloodless evaporation of abnormal tissue areas;
formation of a thin coagulation film at the site of exposure, which protects the underlying tissues.
Advantages of cryogenic treatment:
efficiency up to 96%;
single exposure;
painlessness;
the possibility of performing the procedure on an outpatient basis.
However, it also has a drawback: cervical leukoplakia may reappear. Women with a disturbed menstrual cycle are at risk in this aspect.
Despite the high efficiency of these methods, diathermocoagulation is more often used in Russian clinics. However, it has many side effects, because of which this method is abandoned in developed countries:
severe pain;
bleeding during scab rejection;
long recovery period;
violation of the menstrual cycle;
inflammatory processes of appendages in acute form;
implantation endometriosis;
high risk of relapse.
Treatment of cervical leukoplakia (in any way) is recommended to be carried out in the first half of the menstrual cycle (preferably on day 4-7).
If leukoplakia from the cervix has spread to the vagina, then its treatment is carried out in two stages. First, the doctor deals with the vaginal part of the cervix. After that, it is necessary to wait out one full menstrual cycle, after which you can proceed to the second stage. It involves the removal of abnormal epithelium from areas of the vagina. Thus, it will take about 40 days to achieve the desired result.
There are cases when leukoplakia of the cervix is accompanied by its hypertrophy or obvious deformation. Then you have to resort to surgical methods of treatment. Part of the cervix can be amputated. Operations for the reconstruction of the cervical canal are also common.
Prognosis for cervical leukoplakia
In the case of simple leukoplakia, there is no threat to the health, reproductive function and life of the patient. However, the presence of such a pathology is fraught with the appearance of scars on the uterus, therefore, unborn women require particularly delicate treatment. The presence of leukoplakia will not affect the fetus, but the mother’s health needs to be taken care of, since the presence of atypia poses a risk of degeneration of plaques into oncological neoplasms.
Special control is required:
pregnant women;
women with menstrual disorders caused by hormonal imbalance;
women who have suffered traumatic effects on the uterus;
patients with signs of atypia.
The patient can be considered fully cured after two years after the disappearance of all symptoms.
In general, it can be concluded that a negative prognosis is given only in the case of proliferative leukoplakia of the cervix, the timely non-detection of which leads to the development of cancerous neoplasms.
Prevention of cervical leukoplakia
The rules for the prevention of this deviation are quite simple: they consist in an attentive attitude to women’s health. In principle, these recommendations will help to avoid many other gynecological diseases:
treat inflammatory processes in time;
carefully observe intimate hygiene;
exclude accidental connections;
monitor your weight and body mass index;
exercise while maintaining normal blood circulation in the pelvic organs.
Prevention of mechanical damage to the uterus is a more complex task. For the sake of preserving her health in this regard, the only thing a woman can do on her own is to choose a good gynecologist with extensive work experience and an impeccable reputation.
And, of course, we must not forget about the need to be examined by a female doctor at least twice a year.
