Does cervical lesions require hysterectomy?

It is not necessary to remove the uterus when cervical cancer occurs. Cervical cancer is a relatively common gynecological disease. Generally, there are more malignant tumors, but it can be cured if discovered in time in the early stages. Early marriage, early childbirth, or chaotic sexual life are all causes of cervical cancer, so as a woman, you must respect yourself and know how to protect yourself.

1. What is cervical precancerous lesions? How to diagnose cervical precancerous lesions?

Cervical intraepithelial neoplasia is a precancerous lesion of the cervix caused by persistent infection with human papillomavirus (HPV). CIN is a general term for a group of diseases, including cervical atypical hyperplasia and cervical carcinoma in situ. Precancerous lesions are reversible over a considerable period of time, and the cervix is ​​an organ that is easily exposed. You can do anti-cancer smear tests such as TCT by examining the cervix. Retest the cervix for HPV virus. Then you can do a colposcopy and biopsy to rule out cervical lesions.

2. What are the hazards of cervical precancerous lesions?

Cervical intraepithelial neoplasia includes cervical atypical hyperplasia and cervical carcinoma in situ. These two lesions are precancerous lesions of invasive cervical cancer and are collectively referred to as ClN. The epithelial changes of cervical atypical hyperplasia and cervical carcinoma in situ are of the same nature, but different in degree. The degree of cervical atypical hyperplasia is milder. CIN is divided into three grades according to the degree of cell atypia: grade I refers to mild cervical atypical hyperplasia, grade 2 refers to moderate cervical atypical hyperplasia, and grade 3 refers to severe cervical atypical hyperplasia and cervical carcinoma in situ. CIN of various grades has a tendency to develop into invasive cancer. Generally speaking, the higher the grade, the greater the chance of developing into invasive cancer; the lower the grade, the greater the chance of natural regression. Atypical cervical hyperplasia refers to the abnormal and atypical differentiation of part or most of the cervical epithelial cells. Atypical cervical hyperplasia can occur at the external cervical os, transitional zone, or endocervical surface. Cervical carcinoma in situ refers to atypical hyperplasia of the cervix involving the entire layer of squamous epithelium but without breaking through the basement membrane or invading the stroma, and the lesions are confined to the squamous epithelium.

3. Is cervical precancerous lesion serious? Not serious.

The main cause of cervical cancer is HPV infection, but this process is long. That is to say, it takes a relatively long time for HPV infection to develop into precancerous lesions, namely CIN, and it also takes a long time for CIN to develop into cancer. This provides me with the opportunity to detect cervical cancer early, and even detect and receive timely treatment before it becomes cancerous. This is the ideal state for most patients. Generally speaking, CIN is divided into three levels according to the severity of the lesion, namely CIN I, II, and III. First of all, I want to say that not all people will develop CIN if they are infected with the HPV virus. Only some people will develop it, which depends on your physical condition. Secondly, the presence of CIN does not necessarily mean that it will develop into cervical cancer. It should be said that 3/4 of patients will not even continue to develop, only a very small number of patients will continue to develop, and a very small number of patients will develop into cancer. Therefore, we have plenty of time to treat precancerous lesions. For CINI and II, physical therapy is sufficient, but for CINIII, surgical treatment is definitely required, specifically at least cone biopsy. For patients who undergo cone biopsy, there are two purposes. The first is to make a clear diagnosis and exclude hidden cervical cancer. The second is treatment. For true CIN III, cone biopsy is sufficient, but for those patients who do not have fertility requirements but are near menopause, hysterectomy is also feasible. If you have cervical precancerous lesions, it is recommended that you go to a regular hospital, undergo Leep knife treatment, and undergo regular screening.

4. Is cervical precancerous lesion cervical cancer? Is it hereditary?

It's not cervical cancer. Atypical cervical hyperplasia is a precancerous lesion. It is reversible, meaning that part of the lesion may disappear naturally, but it is also progressive, meaning that the lesion may develop and even become cancerous. Its reversibility and progression are related to the scope and extent of the lesion. It is also related to family genetic susceptibility. In our clinical practice, we have encountered many female patients who brought their sisters for examination after becoming ill and found a large number of cervical precancerous lesions. Therefore, cervical cancer and precancerous lesions are not hereditary but there is susceptibility. Mild atypical hyperplasia is significantly more likely to disappear spontaneously than moderate and severe atypical hyperplasia. Severe atypical hyperplasia is significantly more likely to develop into cancer than mild or moderate atypical hyperplasia. Some scholars also believe that mild atypical hyperplasia of the cervix is ​​a benign abnormal proliferation that can naturally return to normal.

5. What are the symptoms of cervical precancerous lesions?

CIN patients generally do not show obvious symptoms, or only have general symptoms of cervicitis, such as increased leucorrhea. There are also complaints of bloody leucorrhea or a small amount of vaginal bleeding after sexual contact. Gynecological examination may show that the cervix is ​​smooth without obvious inflammation, or there may be cervical congestion or erosion with varying degrees and ranges. It may bleed easily when touched, which is no different from general chronic cervicitis. Therefore, the clinical manifestations of CIN are nonspecific. It cannot be diagnosed based on symptoms and signs alone and is mainly confirmed by histological examination. One is bleeding after sexual intercourse. 70%~80% of cervical cancer patients have this symptom, or uterine bleeding after gynecological examination, which are all signs of cervical precancerous lesions. Fourth, there is mixed blood in the leucorrhea. In addition to uterine bleeding caused by IUD insertion, women with mixed blood in leucorrhea for a long time should be checked in time.

6. How to treat cervical cancer precancerous lesions?

If your cervical biopsy report shows varying degrees of CIN, you must follow up and receive treatment as directed by a professional doctor. There is no need to panic or even despair, because the vast majority of CIN lesions are localized, and the one-time cure rate of conservative treatment is as high as 97%. CIN III does not metastasize, so the survival rate is 100%. 1. CIN I: Test for HPV. If HPV(-), follow-up or anti-inflammatory treatment can be given. If HPV(+), especially high-risk type(+), physical therapy (cryotherapy, laser, microwave) or cervical LEEP treatment can be chosen. 2. CIN II: LEEP treatment is best to exclude the presence of more advanced lesions. Or choose physical therapy (cryotherapy, laser, microwave), etc. 3. CIN III: It is best to choose cervical conization (LEEP) to rule out cervical cancer first. If there is no desire to have children and there are no conditions for follow-up, hysterectomy can be performed.

7. Can precancerous lesions of the uterus be cured?

The so-called precancerous lesions refer to lesions in the body's tissues that cannot be diagnosed as cancer. If left untreated, some patients may develop cancer after a period of time. Therefore, as long as active treatment is given, mainly through surgical treatment, and the diseased tissue is removed, it can be completely cured.

8. Can you get pregnant if you have cervical precancerous lesions?

For patients with CINI, you can choose to receive treatment first and then have a baby, or you can choose to have a baby first and then receive treatment. For patients with CINII or above, you can first undergo LEEP cone biopsy and then have a follow-up examination three months later before getting pregnant. If you are already pregnant and cervical precancerous lesions are detected during prenatal examination, you can continue to get pregnant without worry. It will not get worse during pregnancy. You can wait until after delivery to treat cervical precancerous lesions. Never induce labor or have an abortion. Otherwise, you may regret it if you become infertile in the future.

9. Can cervical cancer be cured?

Cervical cancer is the most common malignant tumor in women and ranks first among female malignant tumors. It is more common in women aged 40-50 and rare in those under 20 years old. The exact cause of cervical cancer is human papillomavirus infection. The following behaviors may be considered as important inducements: early marriage, early childbearing, multiple births, and disordered sexual life. The clinical manifestations of cervical cancer are 1. A small amount of contact bleeding in the early stage of vaginal bleeding or intermittent bleeding after menopause, increased leucorrhea, and increased bleeding in the late stage. Generally, the cauliflower type bleeds easily, while the infiltrative type bleeds later. Occasionally, large blood vessels are eroded, causing fatal bleeding. 2. Vaginal discharge is initially small and odorless. As the cancerous tissue breaks down, the secretions increase and become watery. In the late stage, due to necrosis and infection of the cancerous tissue, a large amount of rice-soup-like or purulent and foul-smelling leucorrhea may appear. 3. Pain: In the late stage of the disease, patients may experience persistent pain in the thighs and lumbosacral region due to infiltration of the parauterine tissue and involvement of the nerves. In addition, if the tumor invades the bladder or rectum, abnormal urination and defecation may occur, and even fistula may form. 4. When going to the hospital for a gynecological examination, pay attention to lesions of the cervix, such as the texture of the cervix, whether there is contact bleeding, etc. The cure rate of early cervical cancer is also very high.

10. How to follow up after treatment of cervical precancerous lesions?

Three months after surgery, HPV and anti-cancer smears and colposcopy should be repeated. As long as all the tests are normal, check again after half a year. Six times every six months. If it is still normal, you can check it again once a year. A total of 20 years were checked. If there is no problem, you can rest assured. The most important thing is that there is no recurrence in the first two years.

11. Do men need to use contraception after treatment of cervical precancerous lesions?

If you want to have a baby after treatment of cervical precancerous lesions, you can have normal sexual intercourse and there is no need for male contraception. If you do not want to have children, you can use male contraceptives for a period of time to completely turn the virus in your body negative.

12. Will cervical precancerous lesions recur after treatment?

After LEEP surgery for cervical precancerous lesions, you need to go to the hospital again three months later for a viral smear and colposcopy check in order to understand the effectiveness of the treatment of cervical lesions. Find out whether there are any residual lesions after the cervical wound heals. If there are still lesions, it is necessary to see whether the lesions are low-grade lesions or high-grade lesions. If the lesion is a low-grade lesion, CINI can be treated with laser. If the lesion is still CINII or above, LEEP surgery needs to be performed again. Some people with a very small cervix may need to be hospitalized and have another LEEP surgery after the bladder and rectum are pushed open. Otherwise, doing it directly may injure the bladder and rectum.