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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 tissues are sent for histological analysis. Throughout the rehabilitation period, a woman should be observed by a doctor and undergo examinations. This is the only way to prevent the development of complications.
Who is electroconization of the cervix?
Indications for the electroconization procedure are various pathological processes involving the tissues of the cervix.
Among those:
Dysplasia.
Erosion and pseudo-erosion.
Cyst.
Hypertrophy of the tissues of the neck.
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 specialists as a precancer. In this case, the disease may not bother the woman in any way, without giving any pathological symptoms. Electroconization allows you to quickly and safely prevent the progression of this pathological process.
After a diagnosis of cervical dysplasia is made, a woman is prescribed electroconization in the following cases:
Second and third degree of dysplasia.
Questionable colposcopy results.
Positive result of cytological and histological examination.
The third degree of dysplasia, leading to deformation of the cervix.
Lack of effect when using other methods of treatment.
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, hepatitis C and B.
A general urine test is required.
A smear is taken for flora and oncocytology.
Before the operation, a biopsy, PCR diagnostics and colposcopy of the affected area are required.
If necessary, antibiotic therapy may be prescribed before the procedure. You can take immunomodulators.
Surgical intervention is carried out 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 under anesthesia.
It consists of several successive steps:
An instrument is inserted into the vagina and with its help all natural secretions are removed.
The woman is then given local anesthesia. When it begins to act, a plastic mirror is inserted into the vagina (metal is not used, since it conducts current).
A solution of adrenaline 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 buttocks of the patient, which will dissipate the current.
The cervix is treated with iodine, which stains pathologically altered areas. This allows you to delineate 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 installed 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 it is required to remove a section that is not cone-shaped, but of a different shape, then the loop can be square or semi-circular.
It is highly desirable to carry out excision in one round of the loop. The electrode is rotated clockwise by 360 °C.
The incised area is removed with forceps.
After the sample is removed, the bleeding vessels are additionally cauterized with a spherical electrode set to a power of 60 watts.
When extensive areas of damage to the cervix 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 the operation. The operation to remove the affected tissue using a loop in America is called LEEP (Loop electrosurgical excision procedure). In EU countries it is called LLETZ.
After the procedure is completed, 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. In case of severe pain after the procedure, the use of painkillers 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, which can take about an hour. It is prescribed in the case when loop electroconization is not available.
When carrying out 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 on the apparatus Surgitron
The Surgitron apparatus is often used for the procedure of electroconization of the cervix. For excision, a surgical electrode is used, which emits radio waves in a high range. Affected tissues under the action of these radio waves generate heat and begin to diverge. At the same time, the woman does not have any scars, no inflammation, no swelling.
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 its yoke, atypical cells begin to die. Scars do not remain, so a woman can easily become pregnant and give birth to a child.
Rehabilitation after electroconization of the cervix
As a rule, the procedure is well tolerated. However, in the first days after the operation, pain in the lower abdomen may occur. They resemble the discomfort that occurs before the start of the next menstruation.
A scanty brownish discharge may appear from the vagina. Menstruation after electroconization may be more abundant 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 be represented by an eschar. It always forms 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 1 months for several years.
Complications are extremely rare. Oncocytology results will be ready in 1-2 weeks.
To heal faster, you must adhere to the following recommendations:
Refrain from sexual activity for up to several months, but not less than 6 weeks.
Don’t 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 bath.
Do not take aspirin after surgery.
Physical overexertion, sports should be avoided.
You can’t use tampons.
You can’t douche.
During the time that vaginal discharge is observed, it is necessary to use sanitary pads and change them in a timely manner.
Possible complications after electroconization of the cervix
After 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 necessary.
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.
Extremely rarely inflammation of the uterine appendages occurs.
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 a possibility of recurrence of the disease, although this is quite rare.
After conization, the risk of preterm birth and miscarriage increases.
Since electroconization is a modern surgical method for the treatment of dysplasia, it will be possible to forget about the operation after 2-3 weeks.
Making a sick leave after electroconization
Sick leave for women after electroconization of the cervix is not provided. She can return to normal life the very next day. Naturally, one should not forget about the recommendations that exist for the rehabilitation period.