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Marina Mikhailovna asks:
What discharge can be after cauterization of cervical dysplasia?
Discharge after laser coagulation.
Cauterization of cervical dysplasia is also carried out with a low-frequency laser. The laser acts primarily on tissue with a high concentration of water. Atypical cells are enlarged due to their high water content, which is why they are the main targets for laser radiation. The cells are evaporated and quickly replaced by new healthy cells of the mucous layer of the cervix. At the same time, during the first 3 to 5 days, small light pink discharge may appear. Sometimes they can resume after 7 to 10 days in small quantities.Discharge after radio wave treatment.
Radio wave therapy is based on the destruction of a pathological focus with radio wave radiation. Under the influence of radio waves, atypical epithelial cells ( mucosal epithelial cells) begin to produce large amounts of energy and self-destruct. The restoration of the mucous layer of the cervix begins fairly quickly. The discharge is scanty, light pink or practically transparent. Lasts, on average, 5 days, but can resume in a week.Discharge after cryodestruction.
During cryodestruction, the lesion is cauterized with liquid nitrogen, less often with carbon dioxide. Under the influence of low temperatures ( minus 150 - 170 degrees) water in precancerous cells crystallizes and they die. During the first 5 - 7 days, the atypical cells die, "melt" and are rejected, so the discharge is especially abundant and watery. With cryodestruction, there is practically no risk of vascular damage, and the discharge is bloodless. If an admixture of blood appears in the discharge, you should urgently consult a gynecologist.When a woman neglects the doctor's recommendations after cauterization of cervical dysplasia, the postoperative wound can become infected, inflamed and fester. In this case, various types of discharge appear - dirty yellow, greenish, with a bad odor. These complications should be treated in time.
- adherence to the principles of personal
Dear Ekaterina!
Cryodestruction of the cervix is \u200b\u200ba simple operation performed annually for millions of women. Under the influence of low temperatures, in particular, liquid nitrogen, tissue destruction occurs during erosion, cervical dysplasia I-II degree, leukoplakia, polyps, retention cysts of the cervix, diseases of the vulva, vagina, perineum. Damaged tissues are removed, and healthy epithelium grows in their place. In some cases, with deep lesions of the cervical canal, re-intervention is required.
In comparison with traditional methods of surgical treatment, cryodestruction is more preferable, because application of this method is possible in a wide range of cases and mainly without anesthesia and anesthesia. After freezing tissues with liquid nitrogen, scars are not formed, and at the same time they remain elastic.
How is cryodestruction going?
Cryodestruction of the cervix is \u200b\u200bperformed in the first phase of the menstrual cycle, no later than the 10th day, but after the end of menstrual flow. Before the operation, it is necessary to undergo an examination by a gynecologist, pass a smear on the vaginal flora, atypical cells and genital infections, complete blood count, undergo colposcopy. Sometimes, if necessary, the doctor prescribes a biopsy and histological analysis.
Treatment of the cervix with liquid nitrogen is performed on an outpatient basis and takes several minutes. The procedure is almost completely painless, as the cold blocks the nerve endings. Due to vasoconstriction, the operation is completely bloodless.
Rehabilitation period
Immediately after the procedure, manifestations of various vegetative reactions are possible: dizziness, fainting, bradycardia, etc. During the first two days, severe pulling pains in the lower abdomen may be felt. Normally, within one month, there is abundant watery discharge from the vagina - hydrorrhea. Bleeding after cryodestruction is rare, but minor bleeding may occur.
If the operation was performed against the background of inflammation of the uterus and vagina, then an acute inflammatory disease of the appendages may occur. Side effects can also occur if the destruction was not carried out correctly, for example, if the walls of the vagina were damaged. Prolonged hydrorrhea (more than 1 month), severe and / or prolonged pain, bleeding from the vagina are the reason for immediate medical attention. Yellow mucous discharge from the vagina with an unpleasant odor can speak of suppuration of the wounds and also require specialist advice.
Normally, the tissues heal completely in 4 to 6 weeks, and the watery discharge disappears in 3 to 4 weeks. Sexual contact is prohibited for two months after the operation. Before resuming sexual activity, it is advisable to visit a gynecologist and make sure that the cervix has fully recovered and there are no signs of possible inflammation. Also, during the recovery period, it is not recommended to visit the bathhouse and sauna. Weight lifting and strenuous physical activity should be avoided.
Best regards, Ksenia.
Hello Ekaterina!
Vaginal discharge in the form of a watery fluid is absolutely normal after cryodestruction. Normally, such discharge lasts for 3-4 weeks, gradually decreases and disappears.
It is not possible to assess how normal the onset of menstruation is in your case on day 10, since the regularity of your monthly cycle is unknown, and on what day of the menstrual cycle cryodestruction was performed.
Normally, the menstrual cycle does not suffer from cryodestruction, the next menstruation comes as expected, but small deviations towards a delay or early onset are considered acceptable.
The first menstruation may be more profuse and with blood clots.
As you know, cryodestruction treatment is the destruction of pathological tissue by freezing it with the help of various refrigerants, most often ultra-low temperature liquid nitrogen (-196 g) is used.
The method is widely used in gynecology for the treatment of cervical erosions, cervititis, cervical dysplasia, condillomas, papillomas, various polyps of the cervix and cervical canal, and in some other cases.
To make it clearer for you what happens to your body after treatment, we will consider the cryodestruction procedure in more detail.
The essence of the method is that the tissues to be processed are instantly cooled to ultra-low temperatures. This leads to freezing of intercellular and intracellular water with the formation of ice microcrystals and an increase in the concentration of cellular substances to a toxic level. The vital activity of the cell is disrupted, membrane and cellular structures are damaged, the movement of protoplasm in the pathological tissue stops. The higher the freezing rate, the deeper and more efficiently the pathological tissue is destroyed. Freezing of tissue is accompanied by a hemostatic effect due to a violation of microcirculation in the capillaries, so the operation itself is not accompanied by bleeding.
The cryodestruction process is the following (the main stages of cryodestruction):
1.Freezing the tissue with liquid nitrogen.
The tissue becomes white, cold, dense, insensitive; this may be accompanied by subjective sensations of mild burning, tingling, minor pain.
2. Hyperemia and collateral edema - within 1-3 hours after surgery.
3. The appearance of epidermal blisters (with serous or hemorrhagic contents) - within 6 - 24 hours;
4. Necrosis is completely rejected within 2 to 6 weeks, leaving an inconspicuous spot; simultaneously with this, epithelialization of the defect and the surrounding tissue occurs;
5. Complete tissue regeneration. All the elements and structures of the epithelium are restored - within 3 - 6 months.
It is with the processes occurring in the tissues of the cervix that vaginal discharge after the procedure is associated.
In 30 minutes after cryodestruction, edema develops in the tissues subjected to cryo-exposure.
Wound healing occurs as an exudative inflammation.
Exudate is a cloudy liquid, rich in protein and cells of a hematogenous and histogenic nature, which sweats from small blood vessels at the site of inflammation. Contains protein, leukocytes, erythrocytes, minerals, cellular elements, often - microbes that caused the inflammatory process.
That is why the healing process is accompanied by profuse watery discharge. Doctors warn the patient about the possibility of discharge before the operation.
The abundance and duration of discharge in each case are individual, depending on the area of \u200b\u200bthe treated surface, and other factors.
On average, the discharge reaches its maximum volume by 4-7 days after surgery. At this time, the zone of necrosis is determined and a scab forms on the surface of the tissues.
Vaginal discharge becomes serous-mucous in nature, pain in the lower abdomen may disturb.
A scab is a thin crust that covers a wound; its formation indicates the beginning of the tissue healing process. The scab begins to recede as the necrotic tissue is rejected, approximately 10-14 days after the operation.
At this time, a blood vessel may be exposed, as a result of which the discharge takes on the appearance of an ichor. With a sharp discharge of the scab, bleeding is possible.
The restoration of the normal epithelial layer begins at the site of the detached crust.
Complete epithelialization of the cervix is \u200b\u200bobserved, as a rule, by the end of 6-8 weeks.
As a rule, cryodestruction is performed on the 6-8th day of the monthly cycle. Therefore, the onset of menstruation on day 10 may indicate a slight disruption in the monthly cycle.
I think you shouldn't worry too much about this, just watch your feelings during the next monthly cycle.
A cause for concern and immediate medical attention should be heavy bleeding, not associated with menstruation, or the appearance of discharge with an unpleasant odor, which may indicate the onset of an infectious process.
For the rest, follow the doctor's recommendations, exclude sexual intercourse, visiting a bathhouse, swimming pools, bathing in a bathtub and in ponds for 4 weeks, and if you have doubts about your health, it is better to consult a doctor and clarify the situation.
Good luck!
http://ru.wikipedia.org/wiki/%D0%AD%D0%BA%D1%81%D1%81%D1%83%D0%B4%D0%B0%D1%82
- local low-temperature effect on pathological foci in the cervical region, as a result of which the altered tissues are destroyed by freezing. It is carried out using liquefied gas cooled to temperatures from -78 to -150 degrees. Cryodestruction of the cervix has a wide range of indications, it is used for erosions and cysts of the cervix, persistent chronic cervicitis, ectropion, leukoplakia, dysplasia and ectopia of the epithelium. It is a bloodless procedure that does not cause scarring in the cervical region. It can be used at any age, including young women planning pregnancy. It is performed on an outpatient basis, does not require anesthesia.
Cryodestruction of the cervix (cryotherapy, cryoablation) is one of the most sparing surgical methods for treating cervical pathology. It has been used in gynecology since the late 80s of the last century. Due to its simplicity, safety, low likelihood of complications and affordable cost, cryodestruction of the cervix does not lose its relevance to this day. The technique is based on the effect of local destruction of soft tissues under the influence of ultra-low temperatures.
For freezing of pathological foci during cryodestruction of the cervix, liquefied gases with a very low boiling point are used. On an outpatient basis, nitrous oxide is most often used, the boiling point of which is - 89.5 degrees, since this gas is suitable for long-term storage. Fast freezing of pathologically altered tissues during cryodestruction of the cervix is \u200b\u200bprovided due to the Joule-Thompson effect. When it gets from a narrow tube into a wide tip, the liquefied gas expands and turns into a gaseous state, while the tip cools down to -65-75 degrees.
The advantages of cryodestruction of the cervix are painlessness due to the analgesic effect of rapid cooling of tissues, bloodlessness resulting from vasospasm, and precise action, which allows you to remove pathological foci without affecting unchanged tissues. Cryodestruction of the cervix does not affect the elasticity of the cervix, therefore it can be used in the treatment of precancerous and background pathology in women of reproductive age. Experts note that a higher efficiency of cervical cryodestruction in young patients is observed in the treatment of precancer, and in the elderly - in the treatment of underlying diseases. The disadvantages of this method are the considerable duration of healing (from 1.5 to 3 weeks), the impossibility of using it for large foci and hard-to-reach neoplasms.
Indications and contraindications
Primary and recurrent erosion and pseudo-erosion in the absence of gross cervical deformity, chronic endocervicitis resistant to conservative therapy, cervical ectropion less than 3 cm in size, coagulated cervical syndrome and degree I and II epithelial dysplasia are considered as indications for cervical cryodestruction. In addition, cryodestruction of the cervix is \u200b\u200bused for polyps of the cervical canal and leukoplakia (in the case of a limited lesion of the cervix without involving the vagina).
Cryodestruction of the cervix is \u200b\u200bnot performed during menstruation, during gestation and breastfeeding. Metrorrhagia, cryoglobulinemia, grade III dysplasia, oncological diseases of the genital organs, uterine fibroids, endometriosis, inflammation of the genitals, low purity of the vagina, specific infections, ruptures of the cervix that prevent tight contact of the tip with the affected area, neoplasia larger than 3 cm, nodular and papillary formations. The use of cryodestruction of the cervix is \u200b\u200bcontraindicated in acute viral and bacterial infections and in the period of exacerbation of therapeutic pathology. The decision on the necessity and admissibility of the procedure is made by the gynecologist.
Preparation for cryodestruction
The procedure is performed on an outpatient basis. Before the start of cryodestruction of the cervix, complaints are collected, anamnesis of the disease is clarified, a gynecological examination and colposcopy are performed, smears are taken to assess the degree of vaginal cleanliness, to identify atypical cells and STDs. According to the indications, a biopsy is prescribed, followed by a histological examination. In some cases, the patient is advised to have a pregnancy test.
For women of reproductive age, cryodestruction of the cervix is \u200b\u200bperformed on the 7-10th day of the cycle. For the procedure in postmenopausal patients, choose any convenient date. The patient should refrain from sexual relations for several days. Before the procedure, it is necessary to conduct a toilet of the genitals, 1-2 hours before cryodestruction of the cervix, a non-steroidal anti-inflammatory drug should be taken. Immediately before using the technique, the doctor explains to the patient the essence and features of cryodestruction, warning of possible hot flashes during the freezing of pathological foci and low-intensity pain in the lower abdomen during or after the procedure.
Methodology
The patient is placed on a gynecological chair. The external genitals and vaginal walls are treated with an antiseptic. The neck is cleaned with a swab soaked in saline. A swab moistened with a weak solution of acetic acid or Lugol's solution with glycerin is introduced, and the neck is processed again to identify altered areas. To carry out cryodestruction of the cervix, a warm tip is inserted into the vagina, placed in the affected area and pressed so that the tip completely covers the area of \u200b\u200bpathologically altered tissues. They turn on the circulation of liquefied gas and record the time using a timer.
Within a few seconds, the handpiece cools rapidly and freezes the underlying tissue. Cryodestruction of the cervix is \u200b\u200bcontinued for 3-5 minutes, then the circulation of the refrigerant is turned off and the tip is moved away from the treated area during thawing, slightly turning it at the time of separation (this avoids cervical rupture when the instrument and frozen tissue stop contacting). Pause for 4-5 minutes, then repeat freezing for 3-5 minutes. After the end of cryodestruction of the cervix, white areas are formed at the site of pathological foci, in the area of \u200b\u200bwhich areas of limited necrosis are subsequently formed. The neck is examined in mirrors and smeared with Monsel paste.
After cryodestruction
After completing the procedure, tachycardia, a feeling of heat and facial flushing are possible. The listed symptoms are a consequence of tissue freezing, do not require special treatment and disappear within about 30 minutes. In some cases, after cryodestruction of the cervix, there is a rapid drop in blood pressure, bradycardia, cold sweat and pallor of the skin in combination with intense pain in the lower abdomen. When these symptoms are detected, diphenhydramine is administered to patients.
After the normalization of the condition of patients who have undergone cryodestruction of the cervix, they are allowed to go home. Sick leave is not required. In the first 1-2 days, pulling pains in the lower abdomen are possible. A number of patients develop hydrorrhea lasting up to 4 weeks. Within 3-5 days after cryodestruction of the cervix, naproxen, diclofenac or their analogues should be taken. For 8 weeks, you must refrain from douching, intense physical activity, sexual intercourse, baths and saunas. Control colposcopy is carried out no earlier than 2 months after cryodestruction of the cervix, the optimal period is considered to be a study after 4 or more months.
The cost of cryodestruction of the cervix in Moscow
The cost of the technique is determined by the type of medical organization (private or public). In addition, the pricing takes into account the reputation of a multidisciplinary or specialized clinic, the level of training of specialists and the characteristics of the equipment used. If the patient wishes to undergo this procedure in a short time (without queuing), the price of cryodestruction of the cervix in Moscow may increase. In addition, an increase in cost is noted with the expansion of the list of diagnostic tests, the appointment of consultations of narrow specialists (for example, when a somatic pathology is detected) and the availability of additional services.
The apparatus for processing tissues with liquid nitrogen is equipped with a manipulator with a tip, through which highly cooled gas is supplied, as a result of the impact, the altered tissues of the uterus are cooled to an extremely low temperature - from -180 to -195 degrees Celsius. For the procedure, gases with a low boiling point are used - liquid nitrogen, nitrous oxide, carbon dioxide. In the container of the cryodestructor, the substance is contained in a liquefied form, when it enters the manipulator it turns into a gaseous state and through the tip goes directly to the pathologically altered tissues.
Cryodestruction of the cervix is \u200b\u200ba minimally invasive surgery to remove pathologically altered tissues of the cervix by exposure to low temperatures.
As a result of exposure to extremely low temperatures, a certain area of \u200b\u200bthe cervix is \u200b\u200bfrozen, while healthy tissues are in a state of hypothermia (chilled, but not frozen). Extreme hypothermia leads to the formation of a zone of tissue cryonecrosis. At the same time, healthy tissues are only cooled, but not negatively affected.
In the zone of cryonecrosis, vascular thrombosis occurs, which leads to impaired blood circulation in the affected area. As a result of the cessation of oxygen access, the process of dying off of the altered tissues begins. The duration of cryonecrosis and the complete destruction of the neoplasm lasts about 2-3 months, after this period, the dead tissue is completely removed.
Indications for cryodestruction of the uterus
Cryodestruction is carried out for various pathologies of the uterus and cervix. Indications for the appointment of cryodestruction of the uterus will be the following pathologies of the female reproductive system:
- Erosion of the cervix;
- The initial stage of cervical dysplasia;
- Condylomas and papillomas in the vagina and vulva;
- Retinal (true) cysts of the cervix;
- Chronic lingering cervicitis of the vaginal segment of the cervix;
- Ectopia and ectropion of the cervix.
Cryodestruction is most often used for cervical erosion, since this pathology belongs to the category of common female diseases. According to medical statistics, about 70% of women experience erosion. The cause of cervical erosion can be various factors - stress during pregnancy, damage during childbirth, endocrine disorders, excess weight.
Preparation for the cryodestruction procedure
Cryodestruction of the cervix is \u200b\u200ba minimally invasive effect and does not require special preparatory measures. Before the appointment of the procedure, a woman must undergo a number of general laboratory tests and an analysis of a smear of the cervical mucosa for microflora and infections. The purpose of such a survey is to exclude the presence of pathological and inflammatory processes in the body at the time of the manipulation.
After a gynecological examination, taking an anamnesis and carrying out standard tests, depending on the results of the examination and the established diagnosis, the attending physician may prescribe some additional studies. These include a biopsy (taking scrapings or pieces of altered cervical tissue) for histological analysis. Such a study is carried out if cancer is suspected. In some cases, a woman is advised to have a test or ultrasound of the uterus to rule out pregnancy.
For several days before the procedure, the woman is recommended complete sexual rest. On the day of the operation, 2 hours before the start of the operation, the patient should take an anti-inflammatory drug, which is selected according to the indications by the attending physician.
Cryodestruction technique
Cryodestruction is carried out on an outpatient basis, possibly in the treatment room of the antenatal clinic, equipped with a gynecological chair. The patient is assigned the date of the procedure, focusing on the menstrual cycle. As a rule, it is performed on the 7-10th day of the cycle after the complete end of menstrual flow.
The affected area is treated with an antiseptic and a solution that stains erosion. This is done so that the surgeon can clearly see the edges of the pathologically altered tissues. As a rule, during the operation, anesthesia is not used due to the fact that the area of \u200b\u200binfluence of the cryodestructor does not have high sensitivity. During the operation, the woman may feel a slight burning sensation or tingling sensation.
A manipulator (cryoprobe) is inserted into a woman's vagina to a depth sufficient to directly affect erosion. After insertion of the manipulator, cooled nitrogen (coolant) is supplied to the handpiece, the impact on the handpiece lasts about 3-5 minutes. At the end of the exposure, the specialist turns off the refrigerant supply, after which the probe is removed. The whole procedure takes about 15-20 minutes.
Postoperative period of cryodestruction
The patient is warned in advance that for some time (2 to 4 weeks) after manipulation from the vagina, there will be abundant watery discharge. Until complete healing, that is, within 2-3 months, a woman needs to stop using tampons. During the first two days after the operation, some side effects are possible - weakness, dizziness, pain in the lower abdomen.
Although there is no need for inpatient observation of the patient, she is recommended to bed rest and the exclusion of physical activity during the rehabilitation period. Sexual contact is strictly prohibited until the tissues of the cervix are completely restored (up to 2 months).
Benefits of uterine cryodestruction
Cryodestruction has a number of undoubted advantages:
- This is a painless procedure with minimal tissue damage;
- Does not require complex and lengthy preparation;
- Affordable;
- It is carried out on an outpatient basis;
- Has no side effects and complications.
Moxibustion with liquid nitrogen of erosion, unlike other methods, can be prescribed even to nulliparous women. This is due to the fact that after the procedure and complete restoration of the cervical tissue, no scars are formed. The cervix does not lose its elasticity, so during labor there is no risk of cracks and tears at the site of exposure.
Contraindications to cryodestruction
This type of erosion treatment is not used if the patient has inflammatory diseases of the reproductive system in any form, since exposure to extremely low temperatures can provoke an exacerbation of the pathological process. Contraindications are also considered infections of the genitourinary system, significant deformation of the cervix, multiple cystic formations with altered glands in the immediate vicinity of the treatment area.
