Diseases of the vulva and vagina

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Заболевания вульвы и влагалища
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Prognosis of vulvar dysplasia is associated with the severity of the disease and the period of development of the disease, the presence of concomitant factors, age indicators and the individual characteristics of the patient. In the absence of proper treatment, atypical hyperplasia can progress to oncological pathology. And a mild degree of dysplasia, when detected in the early stages and following the recommendations for the appropriately prescribed treatment, successfully regresses.

The sooner a visit to the gynecologist follows and the more complex the diagnosis is, the more likely a successful recovery is. In connection with the possibility of relapse, patients with a similar diagnosis are recommended to be monitored by the attending physician, and in especially severe cases, additional monitoring by an oncologist.

Vulvar dysplasia

Dysplasia of the vulvar epithelium presents a particular danger: it is rather difficult to predict its behavior - from persistent remission to episodic exacerbations up to the onset of cancer. Early diagnosis and adequate treatment will help to avoid aggravating consequences and maintain women's health.

Symptoms of vulvar dysplasia

One of the significant problems in diagnosing vulvar dysplasia is the lack of specific symptoms that clearly indicate an ailment. This disease may not manifest itself for a long time, flowing in many patients is asymptomatic or with variational clinical manifestations. Often, pathology is detected during a routine gynecological examination.

Indications for an emergency visit to the gynecological office and for examination for atypical vulvar hyperplasia are:

1
The presence of genital warts. If the external genitalia and / or anus abound in genital warts, this is most likely to indicate a possible vulvar dysplasia
2
Swelling, itching and burning, mucopurulent secretions. In some cases, atypical vulvar hyperplasia is provoked by various kinds of infections that produce puffiness and pathological secretions. However, these same symptoms characterize diseases such as vulvovaginitis or colpitis
3
Dryness, ulceration of the mucous membrane, whitish plaques. By analogy with vulvovaginitis and colpitis, in the case of concomitant infections, atypical hyperplasia is often accompanied by symptoms of another pathology - vulvar kraurosis

The disease is characterized by local / diffuse forms and various severity of the lesion:

1
Mild (first) degree of damage - mild epithelial changes (up to 30%)
2
Moderate (second) degree affects up to 2/3 of the epithelium
3
Severe (third) degree entails complete damage to the epithelium and transformation of the cell nucleus

In view of the blurred clinical picture, the diagnosis of vulvar dysplasia at its initial stage is difficult, which makes atypical vulvar hyperplasia even more dangerous.

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Causes
  • HPV The main cause of the risk of vulvar dysplasia is determined by the human papillomavirus. HPV is one of the most widespread viruses, and more than 30 of its types pose a threat to women's health. Medical studies have found that the greatest danger is the anogenital carcinogenic HPV-16 and HPV-18, responsible for the growth and appearance of genital warts - one of the hallmarks of vulvar dysplasia (atypical hyperplasia).
  • Inflammatory processes. The triggered inflammation of the genitals and vagina that characterize colpitis, vulvitis or bartholinitis are possible precursors of vulvar dysplasia.
  • Age indicators and related factors. The presence of pathology of the vulvar epithelium can also be triggered by neuroendocrine shifts and an imbalance in metabolic processes due to age-related changes. Along with menopausal hormonal disorders, the occurrence of dysplasia is facilitated by several concomitant factors. These include weakened immunity, tobacco smoking, premature sexual intercourse, random sexual intercourse and sexually transmitted infections.

The presence of these points in the patient’s medical history means a potential presence in the risk zone for the occurrence of vulvar dysplasia and is the basis for an urgent appeal to specialists in order to conduct an exhaustive diagnosis.

Diagnostics
  • Inspection Examination of the patient begins with a visit to the gynecological office for examination, which can be supplemented by advanced colposcopy and the use of the Schiller test. Due to the different reactions of healthy and damaged epithelium to iodine, the Schiller test allows you to identify pathological changes in the epithelium. Iodine-negative tissues require a mandatory cytological examination and biopsy, the results of which make the final diagnosis.
  • HPV analysis. Papillomavirus is one of the main factors inducing atypical hyperplasia, which necessitates HPV analysis if there is a suspicion of this pathology. HPV screening is carried out by PCR screening, which allows not only to establish the presence of human papillomavirus in the patient’s biomaterial, but also to accurately determine its type due to the unique DNA of each infectious agent. PCR screening is an effective research method even for sluggish infections.
  • Cytological examination, biopsy, histology. If you suspect atypical vulvar hyperplasia, a cytological examination of epithelial cells is prescribed, the results of which make it possible to judge the specificity and severity of cell atypia, as well as signs of malignant neoplasms. If the diagnosis is confirmed in order to exclude an oncological threat, a biopsy is required with the histology of the selected material, the results of which allow differentiating atypical vulvar hyperplasia from benign lesions of the vulva and oncological diseases.

A comprehensive examination involving specialists from different fields of medicine (in addition to a gynecologist and oncologist, it is advisable to include a venereologist and a dermatologist in the examination) makes it possible to conduct the most comprehensive diagnosis and select effective methods of dealing with the disease focused on the patient's needs.

Treatment of vulvar dysplasia

Fight with vulvar dysplasia should be within the walls of the appropriate institution with the involvement of specialists of the necessary profile. Professional intervention will help to avoid cancer complications and save lives. Due to the availability of the latest equipment and an established team of professionals, a whole range of services is available at the K + 31 Clinic Medical Center for the diagnosis and effective treatment of vulvar dysplasia. The presence of an operating room and a day hospital provide access to various treatment methods, including surgical intervention.

The key to the cure for vulvar dysplasia is an individually oriented course. Get comprehensive advice from leading experts of the K + 31 Clinic Medical Center on women's health issues. Timely consultation, comprehensive diagnosis and effective treatment are the key to your cure and well-being in the future.

Treatment of vulvar dysplasia

Considering the age category, severity of atypia, contraindications and concomitant infections, there are various options for combating the disease:

  • Conservative treatment. It involves the use of sedatives, hormonal therapy, desensitizing drugs, restorative drugs, as well as adherence to a certain diet. It is focused on monitoring the psychological state, leveling local manifestations and achieving possible remission. A positive HPV test requires additional antiviral and immunocorrective prescriptions.
  • Surgical intervention. Severe pathology predetermines surgery. An alternative may be the use of liquid nitrogen, radio waves, laser removal of small foci, but these options are possible only at the initial stages of the disease and are aimed at patients who are not in menopause. In severe atypia, relapse, or large-scale lesions and a clear oncological threat, a superficial vulvectomy is recommended - a surgical operation to excise the upper layer of the skin with subsequent plastic surgery.
  • Organo-sparing methods. Photodynamic therapy can be used to treat a burdened HPV infection by vulvar dysplasia. The PDT method consists in the use of photosensitive substances that accumulate in the cells of the tissue affected by the pathological process. Exposure to light with certain characteristics causes a chemical reaction, resulting in the death of atypical cells.

After surgical treatment, patients are subject to observation in the dispensary. Cytological control is required. Abstinence from a sexual life, refusal to use hygienic tampons and douching, limiting loads are recommended.

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Primary appointment with the leading obstetrician-gynecologist
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Our doctors

Kappusheva
Laura Magomedovna
Deputy chief doctor in gynecology, obstetrician-gynecologist
Kamoeva
Svetlana Viktorovna
Deputy Chief Physician for Obstetrics and Gynecology, obstetrician-gynecologist
Pivovarova
Svetlana Victorovna
Head of the outpatient department, gynecologist, endocrinologist
Shevchuk
Alexei Sergeyevich
Oncogynecology consultant, obstetrician-gynecologist
Pegova
Maria Romanovna
Obstetrician-gynecologist
Smirnova
Angelica Yuryevna
Obstetrician-gynecologist, endocrinologist
Dukhina
Tatiana Alexandrovna
Obstetrician-gynecologist, ultrasound specialist
Sirotinina
Maria Vasilievna
Obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound diagnostics doctor
Grishin
Igor Igorevich
Obstetrician-gynecologist
Gomov
Mikhail Alexandrovich
Consultant in oncogynecology, obstetrician-gynecologist
Kashoyan
Anna Robertovna
Obstetrician-gynecologist, ultrasound diagnostics doctor
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Our clinics

K+31 on Lobachevskogo

st. Lobachevskogo, 42/4

+7 499 999-31-31

Subway
1
11
Prospect Vernadsky Station
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Lobachevsky, we pass the first barrier (security post of the City Clinical Hospital No. 31), turn right at the second barrier (security post K+31)
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K+31 Petrovskie Vorota

1st Kolobovsky pereulok, 4

74999993131

Subway
9
Tsvetnoy Bulvar
10
Trubnaya
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Moving along Petrovsky Boulevard, turn onto st. Petrovka, right after - on the 1st Kolobovsky per. Municipal parking
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Mon-Fri: 08:00 – 21:00
Sat-Sun: 09:00 – 19:00
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Orshanskaya, 16/2; Ak. Pavlova, 22

74999993131

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Molodezhnaya
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