Papillomas on the cervix
The content of the article:
-
The causes of the appearance of pathology
- About the pathogen
- How does infection occur
- Which increases the likelihood of illness
- How does the disease manifest
- Diagnostic methods
- What is the danger
-
How to treat pathology
- General Provisions
- Drug treatment
- Operative treatment
-
Prevention methods
- Specific
- Non-specific
- Video
Papillomas on the cervix appear as a result of human papillomavirus infection. This is a widespread pathology, which mainly affects women aged 30–45 years. Pathology must be treated, and not only to remove neoplasms, but also to fight a viral infection. For this, an integrated approach to therapy is used - a combination of medical and surgical methods.
Papillomas on the cervix have a risk of degeneration into a malignant tumor
The causes of the appearance of pathology
In most cases, the appearance of papillomas is associated with papillomavirus infection (human papillomavirus, HPV, papillomavirus). The virus can infect any area of the skin and mucous membranes, however, the appearance of papillomas on the genitals (cervix, vagina, vulva) is most dangerous due to the high risk of developing malignant diseases.
About the pathogen
The causative agent of the disease is a microorganism from the papillomavirus family. In total, there are more than 600 types of viruses, all of them are capable of infecting the human body and causing the development of various pathologies. About 40 types of HPV are capable of affecting the genitals (including the cervix), among them the most common and dangerous are HPV-16 and HPV-18. It is these viruses that have oncogenic properties, that is, they are capable of causing malignant degeneration of tissues.
How does infection occur
The main route of HPV infection is sexual. Sometimes, even after papillomaviruses get into the genital tract, infection does not occur, since the immune system quickly inactivates foreign particles. In other cases, after entering the body, viruses infect the basal layer of the epithelium, causing the proliferation of epithelial cells. Papillomas on the mucous membrane do not appear immediately, the incubation period is 1-2 months or more.
Which increases the likelihood of illness
Not in all cases of papillomavirus getting into the body develops a clinical picture of papillomatosis and especially cancer. The prevalence of papillomavirus infection is extremely high - one or another type of virus is detected in every 3 women. But most of them do not develop the disease, such women are carriers of the infection.
Whether the disease manifests itself or not depends mainly on the state of immunity - whether the immune system has enough strength to fight the pathogen. All conditions that suppress immunity can increase the likelihood of HPV infection:
- oncological diseases of any localization;
- hypothermia;
- frequent infectious diseases;
- taking certain medications (systemic and local glucocorticoids, cytostatics);
- kidney disease, accompanied by increased protein secretion (glomerulonephritis, renal failure);
- endocrine diseases (diabetes mellitus, hypothyroidism);
- emotional stress, distress, chronic lack of sleep.
It has also been found that the likelihood of HPV infection increases the presence of STDs (sexually transmitted diseases - chlamydia, genital herpes, syphilis, trichomoniasis) and smoking. Papillomas often appear during pregnancy and disappear after childbirth.
How does the disease manifest
In most cases, there are no clinical symptoms. A woman may not even be aware of the presence of neoplasms on the cervix, and pathology is detected during a gynecological examination. Less commonly, nonspecific symptoms are present: bleeding from the genital tract, pain in the abdomen, lethargy, weakness.
Diagnostic methods
Since there are no clinical symptoms in most cases, additional examination is required to detect papillomas on the cervix. Basically, for diagnostics, examination of the cervix in the mirrors, colposcopy, polymerase chain reaction (PCR) are used. If a malignant tumor is suspected, histological examination (biopsy) is indicated.
| Diagnostic method | When research is indicated | Explanation |
| Examination of the cervix in the mirrors | In all cases |
This is the primary diagnostic method that allows you to examine the mucous membrane of the vagina and cervix. What papillomas look like when viewed (see photo): · Look like papillary formations; · The surface is flat, smooth; · Color from pale pink to light brown; · The size is most often from 0.2 to 2 mm, less often more; · Single or multiple (papillomatosis). |
| Colposcopy | In all cases |
Colposcopy allows you to examine the vaginal part of the cervix, for this a special device is used - a colposcope (consists of 2 parts - optical and lighting). The study will detect not only papillomas, but also inflammation of the mucous membrane, erosion, and other neoplasms. Often, for diagnosis, not just an examination of the mucous membrane is carried out, but an extended colposcopy (using various medications). For example, application of acetic acid or Lugol's solution to the mucous membrane makes it possible to identify a pathological focus. |
| PCR | In all cases |
PCR is a diagnostic method used to identify the pathogen. Using PCR, you can determine the type of HPV and its oncogenicity. It is worth noting that positive results can be even in the absence of papillomas, since papillomavirus infection can be latent. |
| PAP test (Pap smear) | At high risk or suspected cancer |
A PAP test should be performed on all women with an increased risk of cancer: · Age over 30; · Pathological changes during colposcopy; · Detection of papillomaviruses of high oncogenic risk. The PAP test detects precancerous or cancerous cells. |
What is the danger
Persistence of HPV in the cervix does not necessarily lead to cancer, because papillomas are benign formations. What then is the danger? The fact is that the presence of papillomas and HPV infection tenfold increases the likelihood of developing cervical cancer.
The danger largely depends on the type of virus:
- HPV types 16 and 18 are the most dangerous, as they cause cervical cancer in 75% of cases;
- HPV types 31, 33, 35, 39, 45, 51, 52, 54, 56, 66, 68 have a high and medium oncogenic risk and can also cause genital cancer;
- HPV 6, 11, 42, 44 are the least dangerous, as they have weak oncogenic properties.
How to treat pathology
There is no specific treatment that would allow getting rid of papillomas. That is why a combined approach is used - local removal of formations is carried out, as well as systemic treatment of a viral infection and strengthening of immunity. For this, medications and surgical methods are used. Folk remedies for the treatment of papillomas on the cervix are not used, since they have low efficacy and are highly likely to lead to the development of severe side effects (burns and damage to the mucous membrane, bleeding, attachment of bacterial flora).
General Provisions
For the period of treatment, it is necessary to eliminate the influence of provoking factors, and also to follow the recommendations aimed at strengthening the immune system:
- eat right (increase your intake of vitamins and proteins);
- avoid hypothermia;
- move more during the day;
- timely treat concomitant diseases (especially infectious and gynecological);
- sleep for at least 7-8 hours;
- avoid emotional overstrain, stress.
In addition, barrier methods of contraception must be used to avoid re-infection.
Drug treatment
Drug treatment has two directions - fighting the virus and removing the build-up. To combat viral infection, antiviral drugs and immunomodulators are used:
- Alfaferon;
- Neovir;
- Cycloferon;
- Acyclovir;
- Isoprinosine.
Unfortunately, there are no antiviral agents that would act against HPV, so antiherpetic agents or drugs that activate the immune response are used. Antiviral therapy is not indicated for everyone; drugs from this group are used for multiple papillomas, confirmed by HPV infection.
Another option for drug treatment is the use of cytotoxic drugs and chemicals for the destruction of papillomas. Among cytostatics, 5-fluorouracil, podophyllin, podophyllotoxin can be used. Chemical destruction of formations can be carried out using drugs such as trichloroacetic acid, nitric acid, Solkoderm. For the treatment of papillomas of the cervix, chemical destruction is rarely used, these methods are used for combined lesions, to remove formations in the anogenital region, on the skin in any other localization.
Operative treatment
In most cases, surgical methods are used to remove papillomas. This is a more radical treatment (in comparison with chemical destruction), relapses develop less often. Papillomas can be removed using electrocautery, laser destruction, cryotherapy, radio wave therapy, or surgical excision. The method of treatment is selected individually.
| Destruction method | Treatment features | Advantages and disadvantages |
| Electrocoagulation | A method of treatment based on exposure to electric current. With electrocoagulation, papillomas are cauterized. Removal of the lesions is performed under local anesthesia. | Electrocoagulation leads to a quick effect, 1-2 sessions are enough to remove papillomas. The method is highly effective - the desired effect is achieved in 85-95% of patients. The disadvantages include a high probability of the formation of long-term non-healing defects on the mucous membrane. |
| Laser destruction | Laser destruction is also performed under local anesthesia. Removal of papillomas is based on exposure to laser light. | The efficiency of laser destruction is 60–90%. The high rate of relapse is explained by the presence of latent viruses in the surrounding tissues, therefore, antiviral therapy must be additionally carried out. |
| Cryotherapy | Cryotherapy is a method of removing papillomas with liquid nitrogen. | The effectiveness of the method is 60-100%, however, there is a frequent development of relapses - papillomas are re-formed in 10-45% of women. The disadvantages of cryotherapy include local inflammation of the mucous membrane. In addition, multiple treatments may be required to achieve the desired effect. |
| Radio wave therapy | The essence of the method of radio wave therapy is the effect of high-frequency waves and their penetration into the tissues. The released energy causes tissue heating and cell evaporation. | After radio wave therapy, tissue healing occurs faster, on average 3-4 days are enough for recovery. In most cases, 1 procedure is sufficient. |
Prevention methods
Papillomas on the cervix are a dangerous pathology that can be prevented. Allocate non-specific and specific methods of prevention.
Specific
Specific prevention is vaccination. To date, vaccination is the most effective and safest method for preventing human papillomavirus infection. This prevents papillomas and protects against cervical cancer.
2 vaccines are registered:
- Cervarix - protects against HPV types 16 and 18;
- Gardasil - protects against HPV types 6, 11, 16 and 18.
Girls aged 10 to 25 years old are subject to vaccination, the course of vaccination consists of the introduction of 3 doses.
The Gardasil vaccine effectively protects against infection with oncogenic HPV strains
Non-specific
Nonspecific prophylaxis will not protect against HPV 100%, but it will significantly reduce the risk of infection. Non-specific methods of prevention have several main directions - prevention of sexual infection, strengthening of immunity, early detection of pathology. The following recommendations will help to strengthen the immune system:
- proper nutrition with sufficient intake of vitamins and proteins;
- physical activity;
- avoidance of hypothermia;
- timely treatment of concomitant diseases;
- the use of drugs strictly after consulting a doctor (especially antibiotics and hormonal agents).
To prevent sexual infection with HPV, barrier contraception (use of condoms) is indicated. Early detection of pathology significantly increases the likelihood of a favorable outcome, therefore it is recommended to regularly undergo gynecological examinations.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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