Leukoplakia Of The Cervix - Is It Scary? Symptoms And Treatment

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

Leukoplakia of the cervix: symptoms and treatment

Leukoplakia of the cervix is a gynecological disease, the mechanism of development of which has not yet been fully understood. Therefore, no specialist can give an answer as to whether a particular patient will have a benign or malignant course of leukoplakia.

The prevalence statistics for cervical leukoplakia vary widely. According to various sources, the disease occurs in 1.1-12.5% of women.

Content:

• Leukoplakia - what is it
• Classification of leukoplakia
• Causes of cervical leukoplakia
• Symptoms of cervical leukoplakia
• Symptoms indicating the degeneration of leukoplakia into cancer
• Pregnancy and leukoplakia
• Diagnostics
• Treatment of cervical leukoplakia
• Answers to popular questions

Leukoplakia - what is it

Leukoplakia is a thickening and keratinization of the epithelium of the vaginal or visible part of the cervix. Translated from Greek, the term "leukoplakia" sounds like "white plaque". In foreign medical sources, this disease is called dyskeratosis or intraepithelial neoplasia.

General pathogenesis. After a pathological effect has been exerted on the cervix, inflammation develops. The body starts a protective process that promotes keratinization. Normally, this should not happen. Over time, the epithelium degenerates, plaques and scales are formed on it. There is no glycogen in these areas of keratosis.

Classification of leukoplakia

Depending on the characteristics of the course of the disease, leukoplakia can be of 3 types:

• Simple leukoplakia. This form of violation is found in the early stages of the development of the disease. The plaques do not rise above the surface of the cervical mucosa, being at the same level with it. If the doctor examines the patient in the usual way, then it will be difficult to detect this form of pathology.
• Warty leukoplakia, which is also called the verrucous form of the disease. White growths are located on top of each other, so the cervix looks bumpy. The doctor will not be able to miss this form of the disease even with a standard gynecological examination.

• Erosive leukoplakia. White plaques appear on the cervix, which will be covered with cracks or erosion.

If leukoplakia is detected, the doctor takes the altered tissue site for histological examination. This will make it possible to understand whether a woman has simple leukoplakia or proliferative. In the simple form of the disease, atypical cells are absent in the tissues. Proliferative leukoplakia is considered a precancerous condition.

Causes of cervical leukoplakia

Scientists have only assumptions about what exactly causes leukoplakia. They believe that both internal and external factors negatively affect the condition of the cervix. Moreover, any of them can start the pathological process.

Internal factors for the development of leukoplakia:

1. Hormonal imbalance. If the pituitary gland, hypothalamus, uterus or ovaries are malfunctioning, hormone production fails. This affects ovulation, the menstrual cycle, there is a failure in the production of estrogen and progesterone. Therefore, leukoplakia of the cervix can be provoked by diseases such as:

2. Endometrial hyperplasia.

   • Uterine fibroids and other tumor processes in the organ.
   • Ovarian dysfunction.

3. Inflammatory process in the genital area:

   • Endometritis.
   • Adnexitis.
   • Vaginitis.
   • Cervicitis.

4. Failure of metabolic processes in the body:

   • Overweight, including obesity of varying severity.
   • Diabetes.
   • Diseases of the thyroid gland.

5. Weakening of immune forces:

   • Immunodeficiency is congenital and acquired during life.
   • Deficiency of vitamins in the body.
   • Treatment with certain drugs. Cytostatics negatively affect the immune system.

External factors that can lead to the development of leukoplakia:

• Injuries to the cervix. They can be obtained during childbirth, during an abortion or other procedures, for example, with hysteroscopy or with diagnostic curettage.

• Any aggressive effect on the cervix, for example, electrocoagulation or chemical treatment.
• Sexually transmitted diseases.
• Infection with chlamydia or HPV.
• Infection with ureaplasmosis, mycoplasma, cytomegalovirus infection.
• Early onset of sexual activity and promiscuous intimate relationships.

Symptoms of cervical leukoplakia

A woman will not be able to notice the symptoms of leukoplakia on her own. Most often, the disease is detected during a gynecological examination. Sometimes patients complain of a certain discomfort, but most often it will be caused not by leukoplakia, but by the factors that provoked it.

These symptoms include:

• Pain during intimacy.
• The appearance of blood after intercourse.
• Change in the nature of the discharge. They can give off an unpleasant odor.
• Burning and itching in the genital area. These symptoms occur when the inflammation has spread to the vagina.

During the examination of the patient, the doctor visualizes the cervix, which is covered with a white film. You cannot remove it with a swab. Detachment of the film is accompanied by the appearance of blood. This characterizes the initial stage of leukoplakia.

If a woman develops a warty form of the disease, then the film will protrude several millimeters above the surface of the neck. It is removed with a swab. Shiny pink shells are visible under it. The plaques can be round or oval.

Symptoms indicating the degeneration of leukoplakia into cancer

It is known that leukoplakia can become malignant. In this case, the woman develops the following symptoms:

• The rapid increase in the size of the affected area.
• The appearance of erosion or seals on the cervix.
• The plaque area loses its uniformity.
• The appearance of an ulcer on leukoplakia.
• Formation of a papilla or warts on leukoplakia.

All of these changes can only be detected by a doctor. Therefore, patients with leukoplakia should regularly visit a gynecologist.

Pregnancy and leukoplakia

If leukoplakia was diagnosed in a woman who wants to become a mother, then first you need to get rid of the pathology and only then start trying to conceive. The disease itself is not capable of harming the health of the fetus or complicating the course of pregnancy. However, during the carrying of a child, the hormonal background changes. Under the influence of hormones, the disease can progress.

If the pathology was detected in a pregnant woman, then her treatment is postponed. Therapy is carried out after delivery. Experts strongly recommend a woman to give birth in a natural way, if there are no other contraindications for this. A prohibition on spontaneous childbirth is a condition in which plaques on the cervix begin to grow rapidly and spread to the vagina. In such a situation, a woman is shown a caesarean section.

Diagnostics

To identify leukoplakia, a woman will need to undergo a comprehensive diagnosis. First, you should visit the gynecologist and tell him about your complaints. The doctor will take a history and examine the woman in the chair. Additional studies that may be assigned:

1. Studying the smear. A smear taken from the vagina and from the cervix is sent for bacterial culture and PCR. This allows you to identify sexually transmitted diseases.
2. Smear cytology. Cytological examination provides information about which cells represent the epithelium. The doctor collects a smear-print from the cervix. The procedure is performed using a special Air brush or spatula. In a woman with leukoplakia, a smear from the cervix shows cells of stratified epithelium. Normally, such cells are present only in its vaginal part. The epithelium is changed, signs of hyperkeratosis are revealed (most of the scales do not have nuclei). It is also possible to detect signs of parakeratosis.

3. Colposcopy. If you suspect leukoplakia, the doctor examines the cervix using a special device - a colposcope. This allows you to detect changes that are invisible to the naked eye. It also becomes possible to visualize altered areas characteristic of a precancerous condition.

   When pathological areas of the cervix are visible when viewed on mirrors, the doctor diagnoses "severe clinical leukoplakia." When violations are detected only when examined using a colposcope, the doctor indicates the colposcopic form of the disease.

   In the latter case, the woman will have iodine-negative zones, which can be detected during the Schiller test. For this, the cervix is treated with iodine solution. A test is considered positive if the entire organ turns brown. A negative test is characterized by the presence of uncolored areas. Areas with leukoplakia do not react to iodine, since there is no glycogen in the altered cells. It is he who gives the brown color when treated with Lugol's solution.

   Also, using a colposcope, you can visualize puncture, which is represented by red dots. Mosaic and areas of the cervix of different thickness are visualized. Such diagnostic signs should be alarming, since they indicate precancerous tissue transformation.

4. Histology. To put this method into practice, you will need to perform a biopsy of the cervix with curettage of its canal. Tissues are taken from the area that has undergone changes the most. Histological examination allows you to assess the condition of the cells and identify atypical formations in them.

   Leukoplakia is characterized by signs such as:

   • Acanthosis.
   • The presence of horny scales, which should not normally be present.
   • Proliferation of stratified epithelial cells.
   • Epithelial tissues are unevenly thickened, since intermediate cells are located between them.
   • Under the stratum corneum is a granular layer.
   • There are signs of hyperkeratosis and parakeratosis
   • The cells are saturated with lymphocytes.
5. Assessment of the work of the ovaries. For this, an ultrasound scan is performed, basal body temperature is measured, etc.
6. Immunogram. This study is prescribed only if indicated.

Treatment of cervical leukoplakia

To get rid of leukoplakia, you need to see a gynecologist. There are various methods to combat the disease. The primary task facing the doctor is to relieve inflammation, if any. You also need to get rid of the factors that triggered the development of leukoplakia.

For the treatment of infectious diseases, antibiotics, antiviral agents, antimycotics are used. The choice of the drug depends on what kind of pathogenic flora reproduces in the woman's genitals.

If the patient is found to have hormonal disorders, then its correction is required. After the treatment is completed, you can focus on getting rid of leukoplakia.

Diathermocoagulation

This method involves treating the cervix with electric currents. Simply put, the altered tissues are cauterized. The current source is a special loop that contacts the affected area. The effectiveness of this method of treatment is 70%. However, this procedure is very painful for a woman. Therefore, not all patients decide on it. The advantages of electrocoagulation include its cheapness and availability. Devices for its implementation are in all gynecological clinics.

In modern medical practice, they try not to resort to such a painful method. If it is still carried out, then it will be implemented in the first phase of the cycle, after the end of menstruation.

The disadvantages of electrocoagulation include:

• Soreness.
• The risk of exacerbation of diseases of the uterus and its appendages.
• The risk of bleeding. Moreover, it can happen both during the procedure and at the recovery stage if the scab begins to recede too early.
• Long rehabilitation period.
• Scar formation in the treatment area. Sometimes it is rather rough and large, and leads to the clogging of the cervical canal. Therefore, electrocoagulation is performed only for women who have already given birth to children.

Cryodestruction

Cryodestruction involves the treatment of the affected area with cold. The efficiency of this method reaches 94%. The pathologically altered tissues are exposed to liquid nitrogen. Cells crystallize, their walls are destroyed and abnormal tissues die off. Treatment time depends on the area of the lesion. The whole procedure takes about 2-5 minutes.

The positive aspects of cryodestruction include:

• No pain.
• High efficiency.
• No bleeding.
• The possibility of realization in nulliparous women.
• No scar after the procedure.

However, cryodestruction has certain disadvantages. For example, there is a possibility of a relapse of the disease. In addition, the cervix can become shorter in size, making it harder to conceive naturally.

Laser treatment

Laser treatment of leukoplakia is the most demanded method. The procedure is carried out in the first phase of the menstrual cycle. For its implementation, the introduction of anesthetic drugs is not required.

There is no direct tissue contact with the device. The altered cells are burned out with a laser beam. The liquid from the cells evaporates, due to which they are destroyed. After such cauterization, a thin film forms on the surface of the mucous membrane. It prevents pathogenic flora from entering the treated area. If leukoplakia has spread to the vagina, then the treatment is carried out in 2 stages. First, the affected cells are removed from the cervix, and then from the vaginal walls.

The advantages of the procedure include:

• No pain.
• High efficiency.
• Possibility of treating nulliparous women.
• Lack of blood.
• Fast recovery. The tissues are completely regenerated after 16-40 days.

However, not every clinic is equipped with the equipment for the procedure. Besides, its cost is quite high.

Radio wave treatment

Treatment of the cervix with radio waves is carried out using the Surgitron apparatus. This method of treatment is highly effective and safe. There is no direct tissue contact with the device. A special device is introduced into the cervical canal, which is a source of radio waves. They destroy abnormal cells by evaporating moisture from them.

The advantages of radio wave therapy include:

• No pain.
• Lack of blood.
• No scar.
• Fast regeneration.

The procedure has no disadvantages. The only drawback of the method is that specialized equipment is not available in all medical institutions.

Chemical coagulation

This method of treatment is reduced to applying a special drug to the cervix - Solkovagin. It contains acids that cauterize the affected tissue.

This treatment can be recommended for nulliparous women. It is not associated with pain or bleeding. The effectiveness of therapy is 75%. However, the preparation does not penetrate to a depth of more than 2.5 mm. Therefore, with severe leukoplakia, it will not allow you to cope with the disease. In addition, large areas of mucous membranes should not be treated with the drug.

Rehabilitation

After treatment of leukoplakia, intimacy must be abandoned for 6 weeks. It is forbidden to swim in hot water, lift heavy objects. You should not visit the sauna and bathhouse.

A woman should refrain from introducing tampons, she should not douche. Intimate hygiene must be performed flawlessly.

In the first week after treatment, liquid discharge may appear from the vagina. This is a natural reaction of the body to the therapy.

Answers to popular questions

• Is it possible to completely get rid of leukoplakia and what is the prognosis? A complete cure can be achieved in 99% of cases. The prognosis is most favorable if the pathology was detected at the early stages of the development of the disease. If the risk factors are not eliminated, then there is the likelihood of relapse. Malignancy of the process is observed in 15% of women.
• Do I need to be registered with such a diagnosis ? After treatment, all women are registered. Every 6 months she will need to visit a gynecologist and take a smear for cytology. Colposcopy and HPV test are mandatory. If after 2 years the disease does not relapse, then the woman is removed from the register.
• Is it possible to get pregnant with cervical leukoplakia? Leukoplakia is not an obstacle to conception. Pregnancy may not occur for other reasons, for example, due to hormonal disruption or a genital infection. You can plan a pregnancy only after getting rid of the pathology.
• Is it possible to get vaccinated against cervical leukoplakia? Yes, you can give the vaccine Gardasil or Cervarix. They prevent HPV infection, which causes both leukoplakia and cervical cancer.
• Is intimacy with leukoplakia possible? Yes, it is possible. However, experts recommend not to delay the treatment of this pathology.

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.