Treatment after conization of the cervix

Conization is an operation to remove an area of altered tissue from the cervix and cervical canal. The removed fragment has a conical shape. The operation is performed to prevent the degeneration of altered tissues into a malignant form. Cervical conization may be performed for diagnostic purposes.

The content of the article

1 When needed
2 Contraindications
3 Purpose of conization
4 Types of surgery
5 How is healing after conization of the cervix
- 5.1 Restrictions
- 5.2 Complications

When needed

The operation is performed with visible pathological changes in the cervix and in the presence of dysplasia of the cervical epithelium in smears.

Among the indications for the procedure, the main ones are:

pathological changes in the cervix;
laboratory-confirmed dysplasia of 2-3 degrees;
negative result of the study discharge from the cervix.

Conditions in which surgical intervention is recommended:

changes in the epithelium revealed during colposcopic examination;
dysplasia of 2-3 degrees;
eversion of the cervical mucosa (ectropion);
erosion;
the presence of polyps;
cicatricial deformities;
leukoplakia;
recurrence of dysplasia after previous treatment by other methods.

Surgery may be performed to clarify the diagnosis. The extracted area is sent to the laboratory for histological analysis, and according to its results, the presence or absence of cervical cancer is judged.

Contraindications

The operation will not be performed if the woman has:

inflammatory process in the vagina;
cervical cancer;
infectious disease;
in the absence of clearly defined boundaries of the transformation of the epithelium;
when the pathological process spreads beyond the cervix;
blood diseases (clotting disorders);
chronic diseases in the stage of decompensation (diabetes mellitus, hypertension, cardio - vascular insufficiency, disorders of the kidneys and liver).

If there are contraindications, treatment is carried out, and cervical conization is postponed until the pathology is eliminated.

Purpose of conization

The main goal of surgery is to remove pathologically altered tissues and prevent the degeneration of the process into a malignant form.

The procedure allows for the diagnosis and treatment of the disease.

During the operation, the doctor removes the affected affected area of the neck within healthy tissue.
The material is sent to the laboratory for histological examination.
If, as a result of the study of healthy areas, cancer or dysplasia is not detected, then the pathology is considered completely cured.
Conization will be considered diagnostic if the results raise doubts about the complete removal of pathological tissues with signs of dysplasia or invasive cancer. In this case, we will talk about other possible methods of combating the disease.

Types of surgery

In medical practice, the following treatment methods are most often used:

electrocoagulation (loop electroconization);
radio waves;
laser;
surgical knife.

The use of loop electrocoagulation can give a small percentage of complications.

Radiosurgery

Recently, most doctors prefer the treatment of radio waves. For the radio wave technique, the Surgitron apparatus is used. Tissue destruction is carried out under the influence of high frequency currents. Using a loop electrode of a suitable size, the affected area is cut out with the capture of 3-4 mm of healthy tissue around the focus and to a depth of 8 mm.

The advantages of radio wave therapy include:

the possibility of using local anesthesia;
lack of bleeding, due to coagulation of blood vessels;
the absence of high temperature in the destruction zone allows minimizing the risk of burns;
the possibility of taking full-fledged material for histological examination;
the percentage of complications after the procedure is minimal.

Healing after conization of the cervix with radio waves lasts on average no more than a month. In the postoperative period, pain in the lower abdomen and scanty spotting may be observed. You should not be afraid of this - this is a normal phenomenon.

Using a laser

Laser surgery is less traumatic. This technique is expensive and high-tech.

The benefits of laser therapy include:

the possibility of accurate dosing of the depth of destruction;
no risk of infection, since the laser beam has a sterilizing effect;
surgery is allowed for extensive lesions;
there is no risk of bleeding, since under the influence of the laser coagulation of the vessels occurs.

Among the disadvantages of the procedure:

high risk of burning healthy tissues;
the operation is preferably performed under general anesthesia, so that the patient can be completely immobilized;
high cost of the procedure.

Their presence is due to the fact that not every surgeon is able to perform such an operation. Rehabilitation after laser therapy is uneventful and, as a rule, quite successful.

With a scalpel

This method is used less frequently than the others, due to the increased risk of complications (perforation, bleeding, scarring). However, it is the use of a knife that makes it possible to obtain better material for histological examination.

Loop electroconization

Excision of the affected tissues is carried out with a loop electrode. The procedure has a low cost, so it is often used in gynecology. But, electroconization has some disadvantages, including bleeding in the postoperative period and scarring.

Stages of the operation:

the introduction of a mirror into the vagina;
removal of vaginal discharge with a cotton swab;
disinfection of the surgical field with Lugol's solution;
injections of an anesthetic mixed with adrenaline to reduce bleeding;
the affected area is cut out with an electrode loop with a capture of 3-5 mm of healthy tissue along the edges and 5 mm in depth;
the removed tissue is sent to the laboratory for research;
to stop bleeding, coagulation of bleeding vessels is carried out.

The duration of the procedure is approximately 15 minutes.

Among the shortcomings of electroconization, it should be noted that it is not always possible to completely remove the pathological site, as a result of which a relapse of the disease is possible.

After the procedure

After the intervention, the patient should stay in the ward for about two hours. In the absence of significant complaints, the doctor can let her go home.

The postoperative period after conization of the cervix may be accompanied by the following symptoms, which are normal:

the presence of aching pain in the lower abdomen;
slight bleeding mixed with blood. There may be an unpleasant odor;
the duration of the discharge can be different: from a week to a month;
the first menstruation after conization can be heavy.

How is healing after conization of the cervix

If the postoperative period proceeds without complications, then the regeneration of the cervix occurs quickly. On the 7-10th day, the scab is separated, formed as a result of coagulation of the vessels, after which the epithelialization of the wound surface begins. Final tissue regeneration occurs by the 3rd or 4th month.

By the time of healing, a control examination of the woman by a gynecologist is prescribed. If the patient has any complaints, then she should visit the doctor ahead of schedule.

The moments that should alert are always discussed and the woman knows what symptoms to pay attention to:

the appearance of copious bleeding;
if the body temperature has risen;
incessant discharge for more than 4 weeks;
if there is discomfort in the vagina in the form of burning or itching;
the appearance of pain in the lower abdomen after a while after the intervention;
increased secretions after they have stopped.

If necessary, local treatment is carried out. Candles or douches may be prescribed. Other additional effects on the cervical mucosa during this period, as a rule, are not required.

After 3-4 months, and then every six months after conization, smears are taken for the presence of atypical cells. In the absence of pathology for three years, an annual medical examination is indicated.