• Cauterization of cervical erosion: consequences, video, photo

    Erosion of the cervix is ​​a defect of the epithelium of varying degrees.

    So, with true erosion, the complete absence of all layers of multilayer flat epithelium in a certain area of ​​the cervix is ​​noted, and in pseudo-erosion it is replaced by a cylindrical one, which is single-row.

    In the treatment of this pathological process, an important place is occupied by destructive methods, in particular cauterization of the cervix. It can be produced by different methods depending on the physical factor used.

    The essence of the techniques is that they lead to the destruction of the surface layers of the epithelium. This then stimulates the basal cells, which begin to actively divide and replace the defect of the epithelium.

    Methods of cauterization of cervical erosion

    Traditionally, the very first method, which involves cauterization of cervical erosion, is diathermocoagulation.

    It consists in electrosurgical coagulation of pathologically altered foci of cervical epithelium. To do this, use high-frequency current, as well as electrodes, which have a different diameter.

    The second method is laser vaporization. It was created not long ago, but has already found wide application in modern gynecology. The essence of the technique lies in the fact that laser tissue is exposed to the cervical tissue, which is defocused. The power of the therapeutic laser beam is from 3 to 6 W.

    Thus, the cauterization of the cervix to treat erosion can be of two types - diathermocoagulation and laser vaporization. Each of these methods has its own advantages and disadvantages, as well as contraindications.

    Cauterization of cervical erosion by diathermocoagulation

    Diathermocoagulation efficacy is 75 to 95% in the treatment of cervical erosion( endocervicosis).

    However, it is absolutely ineffective if the lesion passes to endocervix, that is, to the inner surface of the cervical epithelium. This is a significant lack of cauterization with the help of electric current. As a result, development of dysplasia in this part of the cervix can occur, and it, in turn, is a precancerous pathological process.

    In addition, diathermocoagulation has another drawback. It consists in the fact that during the treatment it is not possible to control the depth of the effect of electric current on the tissue. This creates conditions for cauterization of normal( healthy) tissues.

    In addition, this method is accompanied by the development of complications. They occur in one third of cases, when this method was used for the treatment of endocervicosis.

    The main complications of are the following:

    1. 1) Bleeding that develops as a result of spontaneous rejection of the scab and exposure of the vessel wall
    2. 2) Cicatricial changes in the cervix that can deform it. They develop as a result of proliferation of connective tissue, which has a coarse structure.
    3. 3) Constrictions of the cervical canal that arise against the scarring of
    4. 4) Atresia of the cervical canal as an extreme degree of its stenosis, which creates conditions for the development of hematomas, that is, accumulations of menstrual blood in the uterine cavity with regular menstruation
    5. 5) Pain syndrome - pain localizedin the lower abdomen. They can bother constantly or periodically, significantly impairing the quality of life of the patient.
    All these complications are early, as they are observed in the first two to three days after the procedure. However, with the passage of time, the remote effects of diathermocoagulation may also develop, these include:

    1. 1) Endometriosis - the appearance of endometrial tissue( inner layer of the uterus) outside the uterine cavity. It is also characterized by cyclical changes that are observed during the menstrual cycle
    2. . 2) Ovarian-menstrual cycle disorders, which can be manifested by intermenstrual bleeding, heavy menstruation, etc.
    3. 3) Exacerbation of inflammatory diseases of the genital organs that occur chronically, which is associated with a weakening of local defense mechanisms, for which the cervix( cervical mucus, formation of immunoglobulins A, etc.)
    4. responds 4) The appearance of telangiectasias - areas of dilated vessels thatcan become a source of bleeding at any time, including during intercourse, examination in mirrors, and also lead to the development of chronic pelvic pain syndrome( pain that persists for 6 months or more).
    Given all of the above, it can be concluded that diathermocoagulation should be used to treat only cervical erosions located in the ectocervix( on the vaginal part without going to the cervical canal).

    In addition, it should be given birth to women, because otherwise the probability of developing cervical dystocia in childbirth( a condition in which it does not open as a result of cicatricial changes even with good labor activity) is high.

    Cauterization of cervical erosion by laser

    Laser vaporization is the method of choice in the treatment of endocervicosis in women who did not give birth.

    This is due to the fact that it does not lead to proliferation of connective tissue and cicatricial cervical changes. According to clinical observations, laser vaporization is effective in 60 - 95% of cases of its use.

    This method also has the following advantages:

    1. 1) It is possible to control the depth of laser exposure to the cervical epithelium
    2. 2) Complete removal of the pathological focus, including the development of dysplasia against the background of erosion
    3. 3) There is no persistent swelling of the
    4. tissues 4)The minimal risk of bleeding, as well as almost never observed exacerbation of chronic inflammatory processes of the uterus, appendages and other reproductive organs.
    It should be noted that both diathermocoagulation and laser vaporization have one significant drawback.

    It consists in the fact that with these methods it is not possible to obtain material for histological examination. And as you know, only on the basis of this can make a reliable conclusion about the good quality or malignancy of the process.

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