Electroconization Of The Cervix With Dysplasia: Types, Stages And Complications

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Electroconization of the cervix with dysplasia

Electroconization of the cervix with dysplasia is the removal of the cone-shaped portion of the cervical canal or the portion of the uterus affected by the disease. The extracted tissue is sent for histological analysis. Throughout the entire rehabilitation period, a woman must be observed by a doctor and undergo examinations. This is the only way to prevent the development of complications.

Content:

• Who is cervical electroconization performed?
• Preparatory stage before surgery
• Electroconization of the cervix
• Rehabilitation after electroconization of the cervix
• Possible complications after electroconization of the cervix
• Registration of sick leave after electroconization

Who is cervical electroconization performed?

Indications for the electroconization procedure are various pathological processes involving the tissues of the cervix.

Among those:

• Dysplasia.
• Erosion and pseudo-erosion.
• Cyst.
• Cervical tissue hypertrophy.
• Polyps.
• Cancer diseases.

Electroconization is prescribed only after a cytological smear taken from the cervix confirms the atypical degeneration of cells. It should be understood that dysplasia is considered by those skilled in the art as precancerous. In this case, the disease may not bother a woman in any way, without giving any pathological symptoms. Electroconization allows you to quickly and safely prevent the progression of this pathological process.

After the diagnosis of cervical dysplasia, a woman is prescribed electroconization in the following cases:

• Second and third degree dysplasia.
• Dubious results of the performed colposcopy.
• Positive result of cytological and histological examination.
• The third degree of dysplasia, leading to deformity of the cervix.
• Lack of effect when using other methods of treatment.

It is impossible to carry out the procedure of electroconization of the cervix in acute inflammatory processes and in the detection of cervical cancer.

Preparatory stage before surgery

The operation requires preliminary preparation:

• To begin with, a woman must pass a general blood test, a biochemical blood test, blood for syphilis, for hepatitis C and B.
• A general urine test is mandatory.

• A smear is taken for flora and oncocytology.
• Before the operation, a biopsy, PCR diagnosis and colposcopy of the affected area are required.

If necessary, antibiotic therapy may be prescribed before the procedure. It is possible to take immunomodulators.

Surgical intervention is performed in the first few days after the completion of the next menstrual cycle. The duration of the procedure does not take more than half an hour.

Electroconization of the cervix

Loop electroconization

The operation is performed using anesthesia.

It consists of several successive stages:

• Instrumentation is inserted into the vagina and with its help all natural secretions are removed.
• The woman is then given a local anesthetic. When it begins to work, a plastic mirror is inserted into the vagina (metal is not used, as it conducts current).
• An adrenaline solution is injected into the cervix, which causes vasoconstriction. This will reduce bleeding. Epinephrine can be used for the same purpose.
• An electrode is placed under the patient's buttocks, which will dissipate the current.
• The cervix is treated with iodine, which stains the pathologically altered areas. This allows you to outline the boundaries of the excision. They will be perfectly visible when viewed under a colposcope.
• If necessary, the neck is fixed with bullet forceps.

• Under the control of the colposcope, the doctor cuts out the desired area. This is done using an electrical loop through which a high-frequency current is supplied. The loop is set 5 mm above the zone of atypical cell damage and current is passed through it. The loop itself has the shape of a triangle (for conization, that is, cutting out a cone-shaped section). If you want to remove a section that is not cone-shaped, but of a different shape, then the loop can be square or semi-transverse.
• It is highly desirable to perform excision in one round of the loop. The electrode is rotated 360 ° C clockwise.
• The cut area is removed with forceps.
• After removing the sample, the bleeding vessels are additionally cauterized with a spherical electrode set at a power of 60 W.
• When extensive areas of cervical lesions are observed, additional curettage of the endocervix is necessary.

The resulting tissues are sent for research. Since the electric loop not only cuts out the affected area, but also cauterizes the blood vessels, there is no risk of bleeding during surgery. An operation to remove an affected area of tissue with a loop in America is called LEEP (Loop electrosurgical excision procedure). In the EU countries it is called LLETZ.

After completing the procedure, the woman should be under medical supervision for some time. As a rule, the patient is discharged from the hospital after a day.

If there is a risk of developing bacterial complications, she is prescribed antibiotics. With severe pain after the procedure, the use of pain medications is indicated.

High conization of the cervix

High conization involves the removal of 2-3 cm or more of the length of the cervical canal. This is a rather serious surgical intervention that can take about an hour. It is prescribed in the event that loop electroconization is not available.

When conducting a high conization of the cervix, there is a high risk of stenosis of the cervical canal. This will lead to the fact that in the future the woman will not be able to have children.

Electroconization of the cervix using the Surgitron apparatus

The Surgitron device is often used for the procedure of electroconization of the cervix. For excision, a surgical electrode is used that emits radio waves in a high range. Affected tissues generate heat under the influence of these radio waves and begin to disperse. At the same time, the woman does not have any scars, inflammation, or edema.

The duration of the procedure does not exceed half an hour. The woman is discharged home on the same day. The recovery period after the procedure on the Surgitron apparatus is 2-3 weeks.

The reproductive function after such an operation is preserved in full, since the cervix does not undergo deformation.

Radio wave conization of the cervix

Radio wave conization of the cervix is one of the types of electroconization of the affected area. This method is one of the most advanced. Destruction is carried out using high-frequency current. Under his oppression, atypical cells begin to die. No scars remain, so a woman can easily get pregnant and have a baby.

Rehabilitation after electroconization of the cervix

The procedure is generally well tolerated. However, in the first days after the operation, pain in the lower abdomen may occur. They resemble the uncomfortable sensations that occur before the start of the next menstruation.

A scanty brownish discharge may appear from the vagina. Menses after electroconization may be more profuse and with blood clots. Such phenomena are considered a variant of the norm and after a few months the patient's condition should stabilize. Blood clots may present as a scab coming out. It is always formed after the operation, so you should not worry about this. The scab comes out about a week after the intervention.

2 days after the procedure, the woman should come to see the doctor. He will examine the treatment area and take a smear for oncocytology. In the future, you will need to visit a gynecologist once every 3 months for several years.

Complications are extremely rare. The results for oncocytology will be ready in 1-2 weeks.

For healing to occur faster, you must adhere to the following recommendations:

• Refuse sex for up to several months, but not less than 6 weeks.
• Do not take a bath. You need to wash in the shower, making sure that the water is not too hot.
• Do not visit the sauna and bathhouse.
• Do not take aspirin after surgery.
• Physical stress and sports should be avoided.
• Do not use tampons.
• You can't douche.
• During that time, while vaginal discharge is observed, it is necessary to use sanitary napkins and change them in a timely manner.

Possible complications after electroconization of the cervix

After the surgery, the following complications may develop:

• Bleeding. It is observed in no more than 5% of cases. This complication is associated with damage to the vessel of the cervix and its poor-quality cauterization. As a rule, after 2-3 days, all spotting should stop. If this does not happen, a medical examination is required.
• Stenosis of the cervical canal. This complication develops in 1-5% of cases and leads to the impossibility of subsequent conception.
• After conization, the anatomy of the cervix may change (excessive dilatation of the cervical canal), leading to chronic infections.
• Inflammation of the uterine appendages is extremely rare.
• After the operation, a slight increase in body temperature is possible. If it lasts for several days and exceeds 37.5 ° C, then you need to consult a doctor. It is possible that an infection was introduced during the operation.
• There is also the likelihood of a relapse of the disease, although this is rarely observed.
• After conization, the risk of premature birth and miscarriage increases.

Since electroconization is a modern surgical method for treating dysplasia, it will be possible to forget about the operation after 2-3 weeks.

Registration of sick leave after electroconization

Sick leave for women after the electroconization of the cervix is not provided. She can return to her usual life the next day. Naturally, one should not forget about the recommendations that exist for the rehabilitation period.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.