Radiowave cervical excision: the effects and the postoperative period

Many background cervical pathology require a surgical approach to the treatment. More recently different traumatic surgery and prolonged postoperative period. The introduction of the gynecological practice of the method of radiowave excision allowed to treat cervical pathology with minimal risk of postoperative complications and consequences.

The structure of the cervix

The cervix is ​​the subject of the survey during a pelvic exam. It is as of this lower part of the uterus is possible to judge the presence of inflammation, background and precancerous pathologies.

The cervix is ​​the most narrow portion of the mother body of conical or cylindrical shape. This formed part of the uterus due to the narrowing of the body down towards the vagina. Thus, the uterine cervix is ​​located between the body and the sheath, being a kind of the connecting member.

The structure of the uterine cervix barrier function, which prevents the spread of infection from the vagina. The cervix resembles muscular tube length and width of a few centimeters. Inside this tube is muscular cervical canal that connects the uterine cavity and the vagina. The upper part of the cervical canal - internal os opens into the uterine cavity, which makes a significant portion of the cervix supravaginal department invisible when viewed. In turn, the outer mouth being a bottom edge of the cervical canal opens into the vagina.

Gynecological examination in mirrors doctor examines only the portion of the cervix, which is directly adjacent to the vagina. The normal vaginal surface portion represented pale pink epithelium composed of flat cells multilayer. The cells are arranged in several layers of squamous epithelium.

1. Basal. This layer borders the surrounding muscles, nerves and blood vessels, forming stroma contains immature round cells with a large nucleus. As its maturation, these cells are raised to the higher layers, gradually flattening.
2. Intermediate. The cells are somewhat flattened.
3. Surface. This layer disposed fully mature cells that have a flattened shape and one small core. Flat old cells function according to their purpose and contribute to the renewal of the epithelium.

When changing the cell structure there is a loss of quality characteristics. The cells become misshapen, the number of nuclei increases and the division into layers is lost. These changes are dysplastic precancerous, often treated by excision radiowave.

Cervical canal is lined with a single layer of columnar cells. According to different external characteristics epithelium addition reddish and velvety texture. In the submucosal layer are actively functioning numerous glands continuously producing mucus, moisturizing the vagina. Cervical mucus has a protective function due to its antibacterial properties. Formulation cervical mucus is different in different phases of the cycle and depends on the cyclic estrogen effect.

Thus, the surface of the cervix is ​​covered by two types of epithelium: flat-layered and cylindrical single layer. Two different types of epithelium are connected inside the external os in the area of ​​transformation. According to statistics, this is the area most often identified premalignant and malignant pathology.

The method PBX

Gynecologists point out that the treatment of cervical pathologies should be carried out in a timely manner. This is due to the fact that some pathological conditions are precancerous. Method of treatment of a specialist selected in accordance with clinical pathologies, women's individual characteristics, such as its history and the desire to implement reproductive function.

Many different methods of surgical treatment of traumatic and long-term postoperative period. In this connection, they are not recommended for nulliparous patients. In turn, the radio wave cervical excision procedure is considered to be gentle, in which the surgical removal of the pathological tissues.

radiowave surgery It was founded in 1973. The first radio wave generator "Surgitron" using electromagnetic waves, differing frequency 3.8-4 MHz. In this case, the surrounding tissue damage believed to be minimal.

The device is a radio-wave surgery

It is known that the PBX unit generates waves transmitted to the electrode. When exposed to liquid evaporation is carried tissue intracellularly. Thus, in place of direct exposure section is formed. Surrounding tissues during treatment is practically not exposed, as they absorb liquid divergent wave.

In the treatment electrode unit is not heated. Directly heating occurs only in tissues. The result is the desired coagulation effect, which implies a more rapid healing in the postoperative period. There are no conditions for the development of bleeding.

Radiowave excision involves the use of electrodes of different types:

• loop;
• ball;
• triangular loop;
• scalpel-waveguide.

Russian analogue device "Surgitron" a device "Fotek" emitting argon gas, along with high-frequency waves.

Radiowave surgery treatment is painless. It is noteworthy that after the remote tissue procedures saved for further histological examination.

Advantages and disadvantages of the procedure

Radiowave excision is the optimal method of treatment, which advantages significantly exceed the possible disadvantages.

Gynecologists are the following advantages of using radiowave excision.

1. Minimal damage to surrounding tissues. That is why the necrotic zone is not formed and the adjacent areas are not exposed to injury. damaged area when using radiowave excision three times smaller than when using electrosurgical.
2. Quick regeneration process. The postoperative period is up to two weeks. In particular, when diatermoekstsizii tissue heal for a month or longer.
3. Pain syndrome absent. The cervix does not contain nerve endings.
4. Sterilization wounds. During excision radiowave coagulated vessels. The risk of infection is significantly reduced in the postoperative period.
5. Cosmetic effect. After using radioekstsizii no scar tissue.

The advantages of the method of radiowave excision also include short-term treatment. The procedure for cervical radioekstsizii takes up to half an hour. The duration of treatment depends on the footprint.

Recurrences of disease after the use of radiowave excision does not occur. And after applying the PBX cervix retains its shape. The method of radiowave surgery may be recommended for giving birth to girls.

Indications and contraindications

Radiowave surgery is used in many branches of medicine. Gynecologists called following the indications for the use of radio-wave cervical excision:

• tumor benign nature;
• dysplastic and other premalignant and background processes;
• scar deformation;
• initial stage of malignant tumors;
• the complicated pseudo;
• No effect after using other treatments.

It is noteworthy that excision radiowave can be used both for therapeutic and diagnostic purposes. Although effective and gentle effect radioekstsizii, there are certain contraindications to treatment method.

Gynecologists note the following contraindications to radiowave excision:

• pregnancy and lactation;
• infection of the reproductive organs;
• menstruation;
• diabetes;
• set a pacemaker;
• thrombocytopenia.

Most contraindications are relative and can be eliminated over time. In diabetes there is a long period of healing of wounds of any size. Carrying radiowave excision is possible only after consultation with an endocrinologist and a preliminary examination.

As for thrombocytopenia, this pathology can be both symptomatic and constant. When thrombocytopenia noted problems with blood clotting, susceptibility to bleeding under even minor damage from vessels.

When the pacemaker established radioekstsiziya not carried out in connection with a possible violation of the apparatus. Usually as a treatment alternative techniques are used.

Preparation and methods of

Using radio wave cervical excision requires a certain preparation. First of all, the preparation involves the passage of inspection. It should be remembered that there is a certain period during which the survey is fit for carrying out manipulation.

The main methods of investigation before the radio wave excision include:

• Smear on the flora, which is valid for up to two weeks;
• smear on onkotsitologiyu which fit up to six months;
• colposcopy;
• PCR testing for sexual infections are considered valid up to two months;
• tests for syphilis, hepatitis, HIV - are suitable for two months.

Before any smear onkotsitologiyu following conditions must be met:

• rejection of sexual intercourse, use of lubricants, spermicides and tampons for two days prior to the study;
• amenorrhea and receiving antimicrobials.

If these conditions results may be distorted. In order to perform the stroke for use onkotsitologiyu tsitoschotku or wooden spatula. When swabbing the doctor draws attention to the following deviations:

• cysts and mucosal sites with redness;
• abnormal discharge;
• bleeding;
• the proliferation of the epithelium.

Performing smear onkotsitologiyu helps the doctor determine the tactics of treatment. Upon detection of cervical cancer treatment usually also includes chemotherapy and irradiation.

Results of the study of vaginal smears may indicate the following changes:

• detection of conditionally pathogenic microflora and specific, indicating the inflammatory process;
• bacterial vaginosis;
• abnormal cells.

In identifying inflammation, due to both opportunistic and specific organisms radiowave excision treatment method is not carried out until complete recovery. After the medication the patient carries a second stroke.

During colposcopy determined the impact of the border, carried out a detailed inspection. Clarification of diagnosis. Carried out by performing tests with Lugol's solution and acetic acid, which belong to the advanced embodiment colposcopy.

Performing radiowave cervical excision does not require hospitalization. Radioekstsiziya performed at the beginning of the menstrual cycle, about the fifth or seventh day. Radiowave excision is performed on the gynecological chair. Sometimes you need to implementation of local anesthesia.

loop excision

After exposure of the cervix in the mirrors need to choose the size of the loop. Under the buttocks of the patient to be put under the passive electrode. It sets the desired power. The presence of arcing loops speaks of overcapacity. Insufficient capacity electrode delay caused in the tissues.

When the radio wave excision doctor chooses the cutting mode. Specialist calculates hand movement in order to remove tissue modified to the extent necessary. It is important to completely remove the remove the affected tissue, the healthy parts are not involved. There are two possible movements:

• top down;
• from right to left.

After excision loop doctors sometimes use a ball electrode that acts on the affected tissue for better hemostasis. In identifying atypical cells exposure depth should be at least 5 mm. After radioekstsizii tissue from pathological sites is investigated within the framework of the histological diagnosis.

conization

In fact, this kind of radio wave excision. Handling of an electrode in the form of a triangle. The procedure is performed on the gynecological chair. Going neck outcrop under aseptic conditions. As a rule, experts apply anesthesia due to the fact that the disposal is subject to a larger site. Typically anesthesia achieved by lidocaine.

Under buttocks enclose zero electrode. For conization selected desired electrode size, and then the optimal treatment power is selected. The angle of the electrode is inserted into the cervical canal until the internal os. Conization start position with the second angle. Using a circular motion, the electrode is rotated by 360 degrees. Formed cone is removed, sent to histology. Ballpoint nozzle coagulate tissue to prevent bleeding.

After the radio wave coagulation compulsorily spend histological examination, the results of which determine further treatment strategy. In identifying cancer cells recommended radiation and chemotherapy. Upon confirmation of dysplasia further treatment is required.

The postoperative period

Usually the postoperative period is mild. overall health of the patient is not disturbed, pain is also absent. The patient is under medical supervision for several hours.

During the first day may cause slight pulling pain in the abdomen. In the absence of other pathological symptoms may be concluded that the usual flow of the postoperative period.

After a few days may cause spotting brown color which can be observed up to 20 days. In the event of an unpleasant odor, the temperature rises, changing the color and consistency of secretions should immediately consult a doctor. These symptoms point to the development of the inflammatory process.

Typically, the radio wave excision does not affect the menstrual function. In most cases, the cycle does not get off. On fertility, gestation, birth and subsequent radioekstsizii method has no effect.