General information
What is dysplasia?
Human papillomavirus (HPV) infection is the most common sexually transmitted infection. Over 70% of women in the general population encounter such an infection at least once in their lifetime. Low-risk HPV types (types 6 and 11) mainly cause anogenital warts, while high-risk types (types 16 and 18) can cause epithelial changes with potentially more serious consequences. In most women the infection passes unnoticed and often clears on its own with the help of natural physiological and immune mechanisms. In a smaller proportion of them, the infection can persist for a year or more, and asymptomatic changes that are invisible to the naked eye may appear on the genital mucosa, with the potential to turn into invasive cancer.
These epithelial changes are collectively called dysplasia. They are located mainly on the surface and in the canal of the cervix, on the vaginal walls, the external genitalia, and the perineal and perianal area. Timely detection and correct treatment practically eliminate the danger of their turning into a malignant tumor.
Carrying a high-risk HPV does not necessarily lead to cancer and only signals a possible risk of an existing or upcoming precancerous change. There is absolutely no need to panic!
Men also suffer from HPV-related diseases, which is why primary prevention with a vaccine is given to both girls and boys.
It is worth knowing that there is also HPV-unrelated cervical cancer, and despite its much lower frequency, preventive check-ups with a gynecologist should not be ignored entirely, even in regularly vaccinated women and in women with a negative HPV test.
What is a Dysplasia Center?
A specialized group of experts (oncogynecologists, gynecologists, histopathologists, and clinical laboratory specialists) with technical support and a priority focus on early detection, diagnosis, treatment, and post-treatment follow-up of precancerous and benign changes of the female genitalia.
Looking more broadly at the structure of an effectively working population screening program with primary (vaccine) and secondary (hrHPV test) prevention, the work of a dysplasia center demonstrates in detail the essence of the third main screening direction, called tertiary prevention.
In practice, it is aimed at women with suspicious screening results (a positive hrHPV test or Pap smear) and its goal is to detect and treat in time the identified precancerous lesions before they turn into invasive cancer.
Tertiary prevention is the expert level in modern population screening systems and is carried out by trained gynecologists with additional professional qualifications. Diagnosed invasive carcinomas of the cervix, vagina, and vulva can be admitted and operated on in the hospital's Department of Surgical Gynecology and Pelvic Surgery.
What diagnostic methods are used?
- Cytology (conventional or liquid-based Pap smear)
- Testing for hrHPV (high-risk human papillomaviruses)
- Colposcopy (examination of the cervix and vaginal walls using an optical device)
- Episioscopy (examination of the external genitalia using an optical device)
- Perineoscopy (examination of the perineum, perianal area, and anus using an optical device)
- Biopsy (taking tissue for histological examination and diagnosis)
- Office hysteroscopy (visual and biopsy diagnostics of the cervical canal and the uterine cavity using an optical system)
- Expert histological diagnosis; second opinion on ready-made specimens
The listed diagnostic methods are painless, are applied separately or in combination at the discretion of the treating physician, and are intended to rule out a suspicion or confirm the presence of a precancerous change.
What treatment methods are recommended for dysplasia?
- Laser vaporization of lesions of the cervix, vagina, and vulva
- Laser excision of lesions of the cervix (conization), vagina, and vulva
- Loop electrosurgical excision for complete removal of the transformation zone (LLETZ/LEEP) or partial removal (lesion-only resection) of lesions of the cervix, vagina, and vulva
Diagnosis and treatment of anogenital dysplasia are performed on an outpatient basis (without hospital admission). Depending on the specifics of your case, you will be offered the method with the greatest potential for lasting cure. Local anesthesia ensures comfort during the treatment procedure.
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