To identify the various pathological conditions in the area of ​​cervical colposcopy using a method that allows you to quickly identify changes and appropriate treatment. This fully applies to the problem of HPV infection. In this disease colposcopy Colposcopy - how to prepare it properly?   It is considered to be an indispensable diagnostic method. Colposcopy with the papillomavirus is the most affordable clinical and visual method, which can be supplemented, if necessary, various epithelial tests.

Testing and diagnosis of viral HPV infection

One such test is a specific test with the use of Lugol's solution, which is the second title of Schiller. Conduct tests based on the ability of epithelial cells to absorb the dye and painted in a dark brown color. This is due to the presence of glycogen in the cells.

For the presence of human papillomavirus infection characterized by the following changes in colposcopic picture:

• the presence of the stratum glands. Where ducts are located glands of the mouth, there is a "rim" or zone of keratinization, which indicates the persistence of HPV. In such a case must necessarily be made sighting study - a biopsy with histological examination to rule out the presence of cancer process
• yodnegativnye portions of the epithelium
• the presence of atypical vessels and atypical transformation zone
• "Field" or mosaic
• atsetobely epithelium looks yodnegativnym site during Schiller. Because this diseased area be sure to make a collection of material for subsequent histological examination

During the colposcopy takes significant study of the state of cervical epithelium, as well as those areas on the cervix, which are the pathological changes.

The value of histologic examination

One of the methods of diagnosis of papillomavirus infection, which is produced during the colposcopy, a histological examination of the assessment of morphological tissue changes the picture. This procedure applies to the deferred time. To collect the material requires a biopsy of cervical area with pathological changes. That the procedure had diagnostic value, it is necessary to compare two samples of tissue. One sample is taken from the neck area where the most pronounced change, and the other - with the unmodified portion of the cervix. To obtain material for research, the procedure is performed under the control of a colposcope. The sample should be sure to include not only the epithelium and stroma subject.

Method of histological examination in the diagnosis of HPV has a high predictive value (90%), but has a low sensitivity (50% total). This explains the need to complement histological examination method for diagnosing a viral infection by PCR. This molecular biology method makes it possible to identify the signs of infection, long before the onset of clinical symptoms or changes at the cellular level with high accuracy determines the specific type of virus.

In modern conditions, the method is most prevalent. It belongs to the amplification methods for diagnosis of HPV DNA detection. In carrying out a comprehensive study, which includes exploration and use of histological methods of detecting HPV DNA, we can achieve a significant reduction in morbidity and mortality from cancer Breast cancer - the verdict?   neck. Thanks to this comprehensive survey possible to control the concentration of virus in the body, based on which concludes on the course and prognosis of the disease.

Marina Solovyov

Multiple uterine fibroids are very common. Wherein the fibroids can be located within the muscle layer of the uterus, at or under the serosa mucosa. Depending on the location, size and number of units, as well as the woman's age, her chosen individual treatment.

Multiple uterine fibroids - what is it?

Multiple hysteromyoma occurs in over 80% of women suffering from this disease. How hard it will occur and with what consequences depends on the size, location sites, the rapidity of their growth and age of the woman.

Begins to develop multiple uterine fibroids with simultaneous or divided in small time intervals of several mutations gladkomyshnechnyh cell wall of the uterus. Why this process begins at the present time is not set, but it is supported by high blood levels of female sex hormones. In osnovenom estrogen. But progesterone Progesterone - norm and pathology   also can stimulate tumor growth. Changed the cells start to divide rapidly - so developing a tumor - fibroids.

Hormonal changes that stimulate the growth of fibroids can occur after abortion, pelvic injuries, occurring against the backdrop of long-term infection-pelvic inflammatory disease, severe physical and neuropsychiatric load, stress and so on.

Some fibroids can be positioned as the next, so have a different location, including to treat the same or different types of fibroids - subserous, submucous or interstitial.

Signs

If the fibroids are small, located on the outer surface of the uterus or in the depths of its muscular layer, the disease is often asymptomatic and only found during ultrasound (US).

But even if one myoma node is located under the mucous membrane of the uterus (submucous node) or inside the uterus grows one of the nodes located intramural (within the muscle layer of the uterus), the symptoms can be very characteristic.

Primarily developed cyclic and acyclic bleeding that lead to chronic blood loss and iron-deficiency anemia Iron deficiency anemia: how dangerous it is? . Cyclic bleeding associated with the menstrual cycle - it is long and heavy menstruation (menorrhagia). Acyclic bleeding with the menstrual cycle are not bound and can occur in any of his day (metrorrhagia).

Characteristic for multiple uterine fibroids and pain. They may wear different character. If submucous location of one or more sites of pain usually associated with menstruation - they are paroxysmal spastic character and occur mainly during and before menstruation.

If one or more nodes are located within the muscle layer (interstitial), the pain can be constant, aching - they say that the tumor compresses the surrounding tissues, causing their ischemia (insufficient blood supply).

Finally, for large myoma nodes located under the surface layer of the uterus (subserous), compressing the urinary tract or rectum, pain may appear when urinating or defecating. Disrupted function of these organs.

Treatment

When multiple uterine fibroids treatment is prescribed individually. Thus, in small multiple myomas (less than two centimeters in diameter or 8 weeks of gestation), which are accompanied by copious blood loss, severe pain and infertility are usually used conservative (hormonal) treatment. Initially, these women carried out an active course of hormone therapy Hormone therapy - is it possible to fool nature?   a destination agonist of gonadotropin-releasing hormone (GnRH, such as Zoladex) that completely suppress ovarian function. The course of treatment lasts six months and reduces components and suppress their growth. Then appointed prolonged courses of hormonal contraceptives (eg regulon or Novinet). You can also use an intrauterine hormonal coil Mirena Spiral Mirena: advantages in the application .

When larger (medium, up to six centimeters in diameter) nodes located submucous or intramural most effective treatment is uterine artery embolization. But this method does not usually apply to women who are planning a pregnancy in the future - they held conservative myomectomy, ie surgical removal of fibroids. Sometimes still have to conduct a phased treatment of uterine artery embolization followed by myomectomy.

With several large uterine fibroids conducted staged medical and surgical treatment. The type and scope of operation, as well as surgical access to the operated tissues physician selected individually.

Galina Romanenko