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New title in en.

April 2011

Злокачественные новообразования тела матки есть одними з наиболее важных медико-социальных проблем. Последние десятилетия отмечается рост заболеваемости рака тела матки, и на сегодняшний день в Украине, злокачественные заболевания тела матки занимают первое место среди всех онкогинекологически заболеваний.
Основным методом диагностики рака матки остается диагностическое выскабливание полости матки. Следует подчеркнуть, что в развитых странах в клинической практике в последнее десятилетие почти перестал использоваться такой грубый способ диагностики и лечения заболеваний матки как выскабливание полости матки. На смену ему пришел щадящий метод – гистероскопия, эндоскопический метод обследования, представляющий собой прямое визуальное исследование стенок полости матки и цервикального канала с целью обнаружения внутриматочной патологии. Визуализация достигается с помощью оптической системы - гистероскопа, который вводится через канал шейки матки в полость матки. Гистероскоп снабжен видеокамерой, а при помощи оптоволоконной технологии изображение цервикального канала и полости матки передается на экран монитора. Данная эндоскопическая методика, позволяет установить причину патологических изменений без дополнительных травм, разрезов и варварского выскабливания.
В настоящее время гистероскопия признана золотым стандартом изучения полости матки при подозрении на какую-нибудь патологию эндометрия или внутриполостную патологию матки.
Внешне гистероскоп выглядит как металлическая трубка диаметром 3-5 мм. В основе этого инструмента — оптическое волокно, позволяющее передавать изображение из полости матки через видеокамеру на монитор. На мониторе врач, выполняющий гистероскопию, наблюдает полость матки при большом увеличении. Хорошая визуализация обеспечивается не только качеством оптических устройств, но также и тем, что через специальный канал гистероскопа в полость матки постоянно подается специальный стерильный раствор Турусол. За счет этого стенки матки, в норме соприкасающиеся, отодвигаются друг от друга, отмываются все сгустки крови и достигается коэффициент преломления, обеспечивающий хорошую видимость.
Исследование наиболее целесообразно проводить в фолликулярную фазу, на 6 — 10 дни менструального цикла, так как в эти дни состояние полости оптимально для визуального осмотра. В этот период обеспечивается более полная топическая диагностика полипов, внутриматочных синехий, аномалий развития матки, субмукозной миомы, хронического эндометрита, инородных тел.
Техника проведения исследования. Наружные половые органы и внутреннюю поверхность бедер обрабатывают йодонатом или спиртом. Шейку матки обнажают с помощью влагалищных зеркал и обрабатывают спиртом. Передняя губа шейки матки низводится. Производят зондирование полости матки, отмечают длину матки по зонду. Расширителями Гегера последовательно расширяется цервикальный канал, чтобы обеспечить свободный отток жидкости из полости матки. Постоянное промывание полости матки способствует быстрому удалению крови. Гистероскоп соединяют с источником света и стерильной системой для подачи жидкости, после чего он вводится через цервикальный канал в полость матки. Осмотр начинают с общего ее обзора, обращая внимание на величину и форму полости матки, рельеф ее стенок, состояние эндометрия (окраска, толщина, складчатость, сосудистый рисунок), доступность и состояние устьев маточных труб. Продвигая гистероскоп, осматривают область дна матки, трубные углы, боковые стенки, истмический отдел и цервикальный канал.
Офисная (диагностическая) гистероскопия проводится в условиях гинекологического кабинета без расширения цервикального канала шейки матки (что значительно уменьшает дискомфорт и болевые ощущения во время процедуры). Во время проведения офисной гистероскопии при необходимости можно взять прицельную биопсию, провести диагностику внутреннего состояния матки, бесплодия, нарушений менструального цикла, определить причину кровотечения и устранить ее, а также удалить полип размером до 4 мм.
Офисная гистероскопия проводится как амбулаторная процедура и не требует госпитализации в стационар.
Таким образом, на сегодняшний день, офисная гистероскопия есть наиболее информативным и щадящим методом диагностики патологии предопухолевых и злокачественных образований тела матки.
Обращаем Ваше внимание на то, что в нашей клинике для проведения данного вмешательства используется самый современный гистероскоп фирмы KARL STORZ с диаметром всего 2,9 мм.

EROSION CERVIX

May 2009

Cervical erosion - these words are familiar almost every second woman of reproductive age. However, despite this «familiarity» This pathology is complex and ambiguous, even for specialists. Take note, even the fact that the true erosion is only 5% of cases, the other 95% «eroziy» - so-called pseudo erosion.
Following medical terminology, it should be noted that the term «psevdoeroziya» is more than a dozen other medical terms such as: ektopiya cylindrical epithelium, nabotovi cysts, retentsiyni cysts, follicular cervical erosion, cervical erosion zalozova area transformation zahoyucha or epidermizuyucha psevdoeroziya, zalozovo-cervical muscle hyperplasia, hypertrophy zalozovo-cystic cervical, glandular-stromal hyperplasia, and others. In fact, even scientific experts have different views on this terminology, so let it all remain professional.
So erosion cervix is very broad concept, which encompasses the visible changes on the surface of the cervix, volume, location, causes, and the main treatment which may be different.
Causes of Erosion
Erosion of the cervix can be caused by normal inflammation, travmatyzatsiyeyu during childbirth, abortion or other surgical interventions, hormonal changes as well as camouflage for the initial stage of cancer disease.
How?
The first need to establish the cause of the problem, secondly to examine its nature.
THAT SURVEY to go?
Analysis of discharge to the exclusion of inflammatory genesis. Ultrasound of the brim, if necessary hormonal study panel to exclude hormonal etiology.
To study the erosion of the cervix carried out in-depth study of changes shyytsi uterus using special methods, namely, Pap test, visual tests (VIA) and (VILI), colposcopy, digital kolpohrafiya, if necessary, performed biopsy cervix.
How conducted the test?
§ Pap Test - cytological study of cervical smear cells after special staining. Getting a stroke is a relatively simple procedure performed by gynecologist or obstetrician. After withdrawal of the neck in a mirror, plastic scrub held capture cells from the cervix and tservi Kalnysh channel. After special staining smear study specialist tsytolohom.

§ VIA - visual assessment of changes in cervical mucus after processing 2% solution of acetic acid.

§ VILI - visual assessment of changes in cervical mucus after processing solution lugol.

§ Colposcopy - cervical test method with optical zoom.

§ Digital kolpohrafiya - study of the most changed areas cervix in the picture with digital zoom.

§ Biopsy - capture a small (several millimeters) pieces cervix to investigate histologically, which allows a final diagnosis.

All tests are completely painless. Intake of material takes a few minutes.

How treated?
Therapeutic tactics depend on the results of the survey. Only a gynecologist can determine this or that treatment, it is shown or contraindicated in each case. For example, if test results have diagnosed the true erosion, enough local conservative therapy in the form of candles or tampons. If erosion is found in girls under the age of 23 years, the cause of ektopiya cylindrical epithelium, with normal results kolposkopichnyh and cytological data, in this case does not require any intervention, just dyspansernoho supervision. In other cases show special methods of destruction (chemical destruction, cryodestruction, Electrosurgical, radiohirurhichna and laser destruction).

Which better?
All these methods have their indications and contraindications. In any case, treatment should be erosion on the one hand, radical, that is to delete all changed tissue, the aim of preventing cervical cancer from another careful not to cause cicatrical deformation fabrics, the aim of preserving povnotsinnosti cervix and reproductive function of women.
Last time, increasingly used the treatment of cervical erosion of laser and radio vaporyzatsiyi surgical method, which used a new generation Electrosurgical models - radiohirurhichni that use electromagnetic fluctuations, which significantly reduces the power load on the fabric, increase the ability to regenerate tissue, give the opportunity to get cosmetic effect compared with the results of laser operations with allow you to get material for morphological studies.

IF NOT Treat Erosion?
Availability nelikovanyh eroziy on shyytsi uterus entrance gate opens to viral infection, which is one of the most common infection transmitted through sexual contact, and starts the process peredpuhlynnoyi transformation.

ABOUT CAUSES OF CANCER

May 2009

People often have a misconception about cancer and this prevents its prevention.
What is cancer? Cancer - a malignant tumor, which can be in any organ. Women most often develop in the area of the cervix, uterine body, ovaries and breast. The vast majority of cancers consists of epithelial cells of these organs, but some malignant tumors, including sarcomas, developing muscle cells and connective tissue. Malignant tumor cells become distorted, no longer the law of development and growth, germinating in other tissues and organs. In cases zadavnenyh neoplasm violate functions of all vital organs and systems.
Can you cure cancer? Yes, but only in the initial stages. In the early stages of cervical tumor cure in 100% of cases. This in part is stored menstrual women and genital function. Bahatochyslenyi observation oncologists show that reducing deaths from cervical cancer depends not only on improving treatment methods of how to improve the timely diagnosis and treatment of diseases peredpuhlynnyh
As there is cancer? Cancer and other malignant tumors do not arise suddenly. Developing gradually, malignant tumor becomes the last phase peredpuhlynnyh processes. By peredpuhlynnyh processes include diseases with long, chronic course and benign tumors, which tend pererodzhuvatys in malignant. In tumor precancerous nature enhanced multiply cells, changing their shape and structure, raises metabolism processes. Some pre-cervical disease can take 10-15 years and does not degenerate in malignant, others become malignant over a short period of time. Having pre-processes and turn into cancer under the influence of so-called carcinogenic factors. Among the many theories of the development of cervical cancer deserves attention viral theory termed neoplasia cervical. Oncogenic potential varies considerably papilomavirusiv; ability to initiate change and pre-cancer papilomavirusy conventionally divided into groups of “high” and “low” risk of malignant transformation of infected epithelium. 6.11 HPV types 42, 43, 44 are classified as low-risk types of cancer, types 16, 18, 48, 56 - high risk. However, scientists pay attention that only a papilloma virus infection is not enough to induce tumor growth, indicating the role of other kofaktoriv in carcinogenesis.
Is it possible to prevent cancer? Yes, possibly. It only pom’yataty that the availability nelikovanyh changes shyytsi uterus (erosion, cervicitis, endotservitsyty, polyps, etc..) Opens the entrance gate to the virus, which belongs to the most common infection transmitted through sexual contact, and starts the process peredpuhlynnoyi transformation. To some extent, the emergence of precancerous conditions conducive to smoking and alcohol abuse. Under his influence affects the liver function that takes an active part in the exchange (including sexual homoniv). Therefore, a healthy lifestyle change sexual «revolution» in the sexual culture, timely detection and treatment of pathological changes in the uterus is shyytsi reliable protection against this disease. According to the conclusions of WHO (World Health Organization), cervical cancer at this time should be seen as a disease, which can be prevented.

HOW PREVENT CERVICAL CANCER

April 2009

Cervical cancer is one of the most difficult tests that can vypasty on the fate of women. But everyone has a chance to avoid it.

HOW?

Many oncologists observation shows that reducing deaths from cervical cancer depends not only on improving treatment methods of how to improve the timely diagnosis and treatment peredpuhlynnyh disease. Early diagnosis and timely treatment of precancerous conditions reduces the incidence of cervical cancer in 20 times. This helps maintain the health and lives of hundreds of thousands of women.

What you should know about cervical cancer?

• The emergence and development of cervical cancer is not rapid, but passes gradually through a series of precancerous changes that can last 10-12 years.
• Occurrence of cervical cancer precede violation of division and maturation of cells of cervical mucus. This condition is considered precancerous and called dysplasia.
• dysplasia and even cancer at early stages of asymptomatic flow not accompanied by pains or not typical of allocation.
• To see the pre-change naked eye is difficult, sometimes impossible.

To identify pre-and early stages of cervical cancer is the most effective screening, which includes a deeper study of changes in the uterus shyytsi with special tests, namely the Pap test, visual tests (VIA) and (VILI), colposcopy, digital kolpohrafiyi . The combination of diagnostic tests significantly increases the effectiveness of screening of cervical cancer.

HOW conducted TEST

• Pap test - cytological study of cervical smear cells after special staining. Getting a stroke is a relatively simple procedure performed by gynecologist or obstetrician. After withdrawal of the neck in a mirror, plastic scrub held capture cells from the cervix and tservi Kalnysh channel. After special staining smear study specialist tsytolohom.

• VIA - visual assessment of changes in cervical mucus after processing 2% solution of acetic acid.

• VILI - visual assessment of changes in cervical mucus after processing solution lugol.

• Colposcopy - cervical test method with optical zoom.

• Digital kolpohrafiya - study of the most changed areas cervix in the picture with digital zoom.

All tests are completely painless. Intake of material takes a few minutes.

Irregularity fence material (inappropriate tools, presence of acute inflammatory process) can lead to diagnostic errors.

WHEN TO OBTAIN STUDY RESULTS?

Research results available in 1-2 weeks.

As evidenced by PAP TEST RESULTS

Most women can get information but they are healthy. But sometimes in the swabs is atypiya cell, which is proof peredpuhlynnyh changes. Light atypiya often associated with mild dysplasia, expressed atypiya evidence of severe dysplasia, even the initial cancer. In this case the woman is subject to further examination - target biopsy and cervical tservi Kalnysh channel.

Biopsy - a small seizure (several millimeters) pieces cervix to investigate histologically, which allows a final diagnosis.

Timely detection of dysplasia makes it possible to cure it and prevent the development of cervical cancer. Treatment is conducted in specialized classrooms and clinics.

After treatment of dysplasia should be repeat-depth survey quarterly for 2 years, then annually.

How do I prepare FOR THE TEST?

Special preparation of the test is not required.

Tests carried out before the beginning of instrumental and other medication procedures, preferably in the second half cycle.

Sine qua non of quality of diagnosis is the availability of special tools to collect material

From the ages pass NEED Screening?
Subject to screening women aged 18 to 65 years.

Clinic DERKACH
Additional Information:

Tel. Servant. (0472) 38-21-03
Tel. Cell. 8 (050) 16-84-667
http://www.cdd.net.ua

Conducted monthly educational lectures. Admission is free.