Squamous epithelium in a smear is a medical concept used by doctors who study the health of the reproductive system of women and men. Identification of epithelial cells in biomaterial is carried out in the laboratory, and their number can tell a specialist both about the normal state of the genital area and about various pathological processes occurring inside and outside the human body. To obtain such information, a person must undergo a cytology smear, which is often called a microflora smear.

What is squamous epithelium?

For a gynecologist or urologist, the flat epithelium in a smear for microflora is an important source of information, even though the doctor himself cannot examine these microparticles when taking a smear. Cells and layers of epithelium are detected during the study of biomaterial taken from the surface of the cervical canal and from the walls of the vagina in women or from the urethra in men under a microscope.

Almost our entire body is covered with some kind of protective shell, which we call skin. But the skin in the mouth, around the eyeball, in the vagina, in the urethral canal, etc. is somewhat different because it is not made of such durable material. Such delicate skin, covered with mucous secretions, is usually called the mucous membrane, and its surface layer, which covers the epidermis, is called epithelium.

Despite the fact that the mucous membrane is abundantly supplied with blood vessels, which explains its bright pink or red color, there are no such vessels in the epithelium. Epithelial cells are nourished through the basement membrane.

Despite the fact that the thickness of the epithelium does not exceed 150-200 microns, this coating of internal organs is considered multilayered, i.e. the cells in it are arranged in several layers. Flat epithelium is precisely the closest surface layer of the mucous membrane, consisting of flat-shaped epithelial cells.

There are 3 types of eptheliocytes: superficial, intermediate and basal, located at different levels. The lower layer, closer to the epidermis, is called the basal layer, and a layer of cylindrical (basal) cells that perform a protective function is attached to it.

But our body is constantly in motion and undergoing renewal, which also applies to epithelial cells. In the process of division (proliferation), basal cells form a layer of cells (intermediate cells) that have a complex shape with growths and spines and are located one above the other. Over time, these cells become flat and move into the surface layer, which is renewed regularly once every 5-7 days. Old cells at the very surface of the epithelium are peeled off and, together with mucus and other physiological secretions, come out.

It is this dead squamous epithelium, separated from the main mass, that doctors subsequently find in a smear. It would seem that there is nothing surprising or pathological in this, because this is a natural process of cleansing and renewal of the mucous membrane. In fact, everything depends on the number of detected epithelial cells, and both an increase and a decrease in their number compared to the norm is considered dangerous.

Flat-shaped epithelial cells are found in smears in both men and women, regardless of whether everything is fine with their genitourinary system. Since epithelial renewal is considered a physiologically driven process, it is not surprising that some squamous epithelium will be detected even in a healthy body.

Tests: how to prepare correctly

Sometimes squamous epithelium in a smear may indicate not so much a disease or some non-pathological changes in the body, but rather improper preparation for the test or incorrect taking of a smear. A gynecologist or urologist may prescribe a microflora test if the patient consults him about pain in the pelvic area, redness and swelling of the external genitalia, unusual discharge, as well as symptoms such as burning, itching, pain during urination or sexual intercourse.

Such studies can be prescribed as part of a routine medical examination or when planning pregnancy. In parallel, a urine test is usually prescribed, which helps to identify hidden diseases of the entire urinary system. But they can also manifest themselves in the form of the appearance of epithelial cells and leukocytes in the urine, while a smear allows one to judge only about inflammation at the site of its collection (urethra, vagina or cervical canal).

But no matter what analysis is prescribed, before carrying it out it is necessary to carry out hygienic procedures, i.e. thoroughly rinse the external genitalia with water without using soap or other hygiene products. If they plan to take a smear from the vagina, women think that they need to thoroughly rinse everything inside using douches. In fact, this cannot be done, since the results of the analysis will be distorted (it will not show the real content of leukocytes and epithelial cells separated from the walls).

In order for the smear results to be reliable, it is recommended to abstain from sexual intercourse and the use of contraception two days before the procedure. A visit to the toilet for minor needs should occur no later than 1.5-2 hours before the procedure.

If the cause of inflammation of the cervical tissue is radiant fungi (actinomycetes), a yellowish granular coating is found at the site of the lesion, and Candida fungi leave behind a white mass resembling cottage cheese (grainy and with a sour smell), which is very easily removed from the reddened surface.

A similar plaque is observed in leukoplakia (hyperkeratosis), a disease in which keratinization of the mucous membrane occurs (normally, keratinization of the mucous membrane is not typical). But in this case, unlike a fungal infection, a whitish or grayish coating (it can form on both the cervix and the vaginal mucosa) is difficult to remove, and the smear reveals scales of squamous epithelium, which are the cytoplasm of a cell without a nucleus.

By the way, sometimes doctors find not individual cells in a smear, but layers of squamous epithelium. If these are single formations, there is no need to worry too much, because the cells of the epithelium of the uterus and vagina are arranged in layers, so it is not surprising if they move away from the total mass in a whole area during cell renewal. But if there are a lot of such layers, this may be evidence of dysplastic processes in the uterus (dysplasia, erosion, endometriosis, cervical leukoplakia, precancerous conditions and cervical cancer), so further research and consultation with a gynecologist, and possibly an oncologist, are required.

Acute cervicitis is characterized by the presence of a large number of leukocytes in the smear (leukocytosis), lymphocytes and histiocytes appear, and cylindrical and squamous epithelium are detected. In this case, the cells of the columnar epithelium (basal layer) have an enlarged nucleus, and the flat epithelium of the surface layer in the smear has dystrophic changes (for example, scales appear that do not contain nuclei).

If the disease proceeds in a sluggish form for a long time, large numbers of columnar epithelial cells will be detected in smears, having different sizes and signs of destruction of cellular structures.

• urethritis (inflammatory process in the tissues of the urethra - urethra, which can be diagnosed in patients of both sexes).

Flat epithelium in a smear in men

For men who consult a urologist usually about various discharges from the penis, as well as such unpleasant symptoms as itching, burning and inflammation of the tissues in the urethra, a smear for microflora is taken from the urethra. In addition to bacteria, viruses, fungi and other microorganisms, exfoliated cells of flat and columnar epithelium can also be found in the mucous, whitish or purulent secretion. The urethral mucosa has a slightly different structure, so a small number of basal cells is not a pathology.

If the number of epithelial cells in the smear is higher than normal, we are talking about tissue destruction. So a large amount of flat epithelium, as in the case of women, most often indicates an inflammatory process in the genitourinary system. In this case, it is necessary to take into account not only the urinary organs (kidneys, bladder, urethra).

The inflammatory process can also be localized in the seminal sacs (inflammation of the testicle or orchitis) or the prostate gland (inflammation of the prostate or prostatitis), which are classified as genitals. And since the organs of the urinary and reproductive systems have a common outlet (urethra or urethra), there may be more reasons for discharge from the penis in men than in women, whose outlets, although located nearby, are still separated, which facilitates diagnosis when taking a smear correctly.

If we are talking about an inflammatory process, the smears will also necessarily show an increase in the level of leukocytes (more than 5 units per field of view), which are released by the immune system to fight the infection. Bacteriological studies also reveal the causative agents of the disease, which once again suggests that the appearance of squamous epithelium in the smear is not accidental.

If neither infection nor leukocytes are found in the smears, then we are talking about hyperkeratic processes (leukoplakia, etc.), which can be localized in various areas of the mucous membrane throughout the body. But you need to understand that the amount of squamous epithelium may increase slightly compared to the norm as the human body ages. Although in men this process is not so pronounced, doctors still note some changes in smear tests that are not related to genitourinary diseases.

In both women and men, the increase in the number of epithelial cells in the smear may be temporarily increased due to the use of topical agents. In this case, the situation can be considered as an unusual manifestation of an allergic reaction to the medicine. By analogy, the skin may experience itching, redness and flaking, which is also due to the rejection of surface epithelial cells.

As for the reduced number of epithelial cells in the smear, for young women this is considered an alarming symptom. With the onset of menopause, a decrease in the production of the female hormone estrogen leads to a decrease in such cells in tests, which is considered a physiologically determined age-related process. Disruption of the hormonal balance in the direction of decreased estrogen production in young women before menopause is fraught with big troubles in the form of disruption of the internal environment of the vagina and activation of pathogenic microflora.

With estrogen deficiency, gradual atrophy of vaginal cells occurs, which manifests itself in the absence of natural ovulation discharge, vaginal dryness during sexual intercourse, small vaginal spotting bleeding, burning and itching in the vagina, and frequent urge to urinate. All these are quite dangerous symptoms that can have dire consequences and cause infertility in women of childbearing age. Therefore, it is undesirable to ignore such symptoms.

Consequences and complications

In a smear for microflora, you can detect different types of epithelium: flat superficial, transitional, cylindrical, which lines the cervical canal and is periodically replaced by squamous epithelial cells. There is nothing pathological in the fact that these cells are present in biological material. This is the result of physiological processes occurring in the body. Women may have fewer such cells, women may have more, but this is also due only to the structure of their genital organs. And if the number of cells of a particular type when studying a biomaterial under a microscope does not exceed 15 units in the field of view, there is nothing particularly to worry about.

But if the indicators are too high or below the norm, this is already a reason to specifically take care of your health. Especially when it comes to women of reproductive age.

An increased amount of squamous epithelium in a smear most often indicates inflammatory processes in the urethra or vagina - organs whose surface is covered with a delicate mucous membrane. And as we know, not a single inflammatory process, especially one that lasts for a long time, goes away without a trace. Timely treatment of an acute inflammatory process, which may be indicated by a large number of exfoliated squamous epithelial cells, helps prevent possible complications.

For example, the transition to a chronic form of vaginitis threatens in the future inflammatory processes of the external genital organs, cervical erosion, inflammation of the endometrium, which in turn can eventually lead to dysplastic processes (dysplasia of uterine tissue, endometriosis, cervical cancer). In childhood, vaginitis is fraught with fusion of the labia minora and labia majora in girls.

The inflammatory process can lead to thickening of the mucosal tissue. Metabolic processes are disrupted, cellular respiration is disrupted, and mucosal tissue atrophies. Cracks and erosions may appear on the mucous membrane, which not only become an obstacle to pleasure during sexual intercourse, but also become a breeding ground for the spread of infection. If vaginitis itself is not always caused by an infection, then the appearance of various lesions on the mucous membrane will provoke its attachment.

An infection, especially of a bacterial nature, has the ability to cover increasingly larger areas, i.e. it will move upward, affecting the organs of the urinary system.

Chronic cervicitis can have identical consequences. The infection will gradually spread to other organs, causing inflammation of the appendages, bladder, and peritoneum. Its result may be the appearance of adhesions on internal organs and the development of cancer (cervical cancer does not develop as often against the background of inflammation, but such a danger still exists). In addition, the mere appearance of a large number of cylindrical and flat epithelial cells in a smear may indicate the initial stage of cancer without symptoms of cervicitis.

Urethritis in women, in the vast majority of cases caused by an infectious factor, although damage to the urethra can also be caused by urolithiasis, can cause disruption of the vaginal microflora, inflammation of the bladder and even the kidneys if the infection spreads to them.

In men, untimely or poor-quality treatment of urethritis (and even more so any therapeutic measures) causes many unpleasant consequences that will also affect sexual life:

• development of prostatitis, and as a consequence of prostate adenoma,
• the appearance of vesiculitis, orchitis and colliculitis (inflammatory processes in the seminal vesicles, testicles or seminal tubercle),
• development of balanoposthitis (inflammation of the penis in the foreskin area), etc.

Long-term inflammation in the urethra can lead to the appearance of strictures, i.e. to a narrowing of the urethra, which creates problems with urine removal from the body and often requires surgical intervention.

Patients with inflammatory diseases of the genitourinary system begin to experience problems of a sexual and psychological nature. Pain during sexual intercourse causes refusal of sexual intercourse and constant dissatisfaction of sexual partners. Quarrels and scandals begin in the family, which can also be considered a distant consequence of a careless attitude towards the appearance of a large number of epithelial cells in the smear.

Although no less sexual problems can be observed in women with an insufficient amount of epithelium in smears, in whom the lack of lubrication in the vagina leads to pain and irritation of the mucous membranes during sexual intercourse.

But pathologies in which the composition of the smear changes have much more unpleasant consequences, considering that they sometimes become an obstacle to conceiving a child. And infertility of one of the spouses often leads to family breakdown.

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Prevention and prognosis

When it comes to human diseases, the prognosis for their treatment depends on many factors, so it is never one hundred percent. Flat epithelium appears in a smear taken from the genital organs of men and women, depending on its quantity, it can indicate various pathologies caused by hormonal disorders, inflammation, infection, malfunctions of the immune system, etc. It is clear that treatment in each specific case will be considered individually, and its effectiveness will depend on the competence of the doctor.

But the prognosis of treatment is influenced not only by the prescribed treatment. The timing of seeking help also plays a big role. The sooner the disease is detected, the greater the chance of saying goodbye to it without consequences and complications. This applies to both inflammatory pathologies and oncological diseases, where we are no longer talking about health, but about the life of the patient.

It is clear that compliance with the doctor’s requirements will definitely affect the prognosis of treatment. If the patient does not want to undergo the full course of treatment, one usually cannot count on a good, lasting result. There is a high risk that the disease will return after a while.

Let us not once again delve into the details of the consequences that can await a person if he does not take any measures to treat the disease. It’s better to talk about how to make treatment more effective.

When treating infectious and inflammatory diseases of the genitourinary system, it is very important:

• Maintain genital hygiene. You will have to wash even more often than usual, especially during menstruation.
• You will also have to change your underwear and intimate hygiene products (tampons, pads) more often.
• All treatment procedures should be carried out after hands are thoroughly washed with soap. You should also wash your hands after performing medical procedures.
• The genitals, where the infection is hidden, require care using a separate towel. It would be better if they were disposable napkins. Otherwise, the towel will have to be washed and ironed daily with a hot iron.
• Particular attention will have to be paid to underwear. It should be made from natural fabrics, “breathable”, because the “greenhouse” effect created by synthetics only promotes the proliferation of pathogenic microflora.
• During treatment of the disease, sexual contact should be avoided. This will help prevent secondary infection and the spread of infection to other people, in particular to a sexual partner. Failure to comply with this requirement is one of the reasons for the prevalence of sexually transmitted diseases. Some patients believe that once they have started treatment, they are no longer contagious. Unprotected sex is especially dangerous.
• It is important to understand that if two people regularly have sexual intercourse, and one of them is diagnosed with an infectious disease, both partners should be treated. Even if we are not talking about sexually transmitted diseases, for example, candidiasis or vaginitis caused by opportunistic microflora, some preventive measures in the form of treating the penis with antiseptics that are effective against bacteria and fungi will not hurt. Especially when you consider that not everyone can boast of strong immunity.
• Treatment procedures prescribed by a doctor must be performed regularly and in full. Treatment should not be stopped just because the symptoms of the disease disappear. It is necessary to complete a full therapeutic course and then, if necessary, resort to preventive measures.

But any disease is easier to prevent than to cure. It is this truth that you need to be guided in your life so that there are fewer unpleasant moments in it.

To avoid infectious and inflammatory diseases of a urogynecological nature, not much is needed. It is worth paying attention to your sex life. Even if your sexual partner is permanent, you need to carefully monitor your health. After sexual intercourse, hygiene procedures will help prevent possible infection.

If we are talking about casual sex, it is imperative to use high-quality personal protective equipment (condom). And again, do not forget about genital hygiene, trying to take a shower as soon as possible.

Wearing underwear made from natural fabrics will help prevent the proliferation of opportunistic microflora, which loves places where it is warm and humid. Irritation of delicate tissues can be caused by increased humidity, as well as allergens contained in scented pads, synthetic underwear, and some intimate hygiene products, which are best avoided.

As for the prevention of diseases in which the squamous epithelium in the smear differs in quantity from the established norm, here the observance of intimate hygiene, proper nutrition, which provides the body with useful substances necessary for strong immunity, and caution in sexual contacts come to the fore. An important role is also played by maintaining the general health of the body and timely treatment of infectious diseases, regardless of their location. You must always remember the ability of infection to spread throughout the body through the blood and lymph in order to prevent such a danger in time.

The meaning of the word “epithelium” means a layer of cells that line the mucous membrane of internal organs and the inner surface of the body. Its purpose is to protect the internal and external person from a variety of infections and mechanical injuries.

Types of epithelial tissues

There are several types of epithelial tissues:
- cubic,
- flat,
- cylindrical,
- flickering,
- pseudo-multilayer,
- multilayer.

Cuboidal epithelium forms renal tubules and performs a secretory function. Cells of this type resemble the shape of a cube in cross-section, as evidenced by its appearance.

Flat - represents thin cells tightly connected to each other. They form a layer on the walls of the capillaries and lungs. These cells serve as an indicator of a person's health when a urine sample is collected. The thing is. that in a healthy person the number of squamous epithelial cells in the urine is insignificant, with developing pathology their number increases significantly.

Columnar epithelium envelops the walls of the intestines and stomach. The shape of such cells is similar in appearance to a cylinder; they are narrow and tall. The main function of columnar epithelial cells is the secretion of mucus, which can protect internal organs from cell self-digestion. In addition, they help promote food movement.

Ciliated epithelial cells line the walls of the spinal canal, respiratory tract, oviducts and ventricles of the brain. The main difference from the cylindrical type is the presence of a large number of cilia.

Pseudostratified epithelium covers the urinary and respiratory tracts, forming only one row of cells.

Stratified epithelia contain several layers of cells, thereby protecting the organs they cover from damage and the leakage of various substances.

Types of squamous epithelium

Unilayer is a row of cells attached to the basement membrane. Cells of this type of epithelium cover the cornea of ​​the eye from the back, line the cavities of the heart, lymphatic, and blood vessels and form the outer side of the capsule of the renal glomerulus.

The non-keratinizing type of squamous epithelium creates a covering layer of the mucous membrane of the esophagus and mouth, lines the transitional region of the anal canal, vagina, envelops the outer surface of the cornea of ​​the eye, as well as the area of ​​the female urethra. In its composition, three layers can be distinguished: basal, spinous or intermediate and superficial.

The stratum corneum is superficial; its scales fall off over time, and cells from the underlying layers come in their place.

The cells of the keratinizing epithelium extend over the entire surface of the skin, making up its epidermis. The keratinizing epithelium is formed from five layers: basal, spinous, granular, shiny and horny.

Practice has shown that women in the middle period of reproductive activity are usually susceptible to reactive changes in the epithelium of the genital organs. This period corresponds to 20-27 years.

Pathological changes in the cervix may not show characteristic signs. They can only be identified through a regular gynecological examination. Women of reproductive age need to undergo regular cytological examinations of the vaginal microflora at least once a year.

Layers of squamous epithelium line the walls of the vagina, while the surface of the cervical canal of the cervix is ​​covered with a layer of columnar cells.

The number of births determines the shape of the cervix: normally it varies from cone-shaped to cylindrical.

The surface of the neck is smooth, pink in color with a characteristic shine. During a gynecological examination, mucosal defects and pathological formations should not be observed. The Schiller test is normally uniformly and uniformly colored brown.

Cytological examination of the mucous membrane on the test specimen should reveal single and squamous epithelial cells. It is taken into account that the number of leukocytes may fluctuate depending on the current menstrual phase.

Leukocytes are characterized by pure cytoplasm, intact nuclei and have no signs of phagocytosis. The smear contains mucus and metaplastic cells in single quantities.

Reactive Changes

Polyps of the cervical canal

Abortions and inaccurate gynecological manipulations, injuries during sexual intercourse lead to protrusion of tissue into the cervical canal, forming a polyp. The formation of a polyp can be promoted by persistent inflammation of the genital tract. This pathology is usually removed surgically.

Timely diagnosis

To identify reactive pathologies of the mucous surfaces of the cervix, it is necessary to regularly visit a gynecologist and carry out the necessary laboratory tests.

Particular attention should be paid in case of any changes in the menstrual cycle: an increase in the amount of discharge and its structure, the appearance of an unpleasant odor. The inflammatory process may be indicated by the appearance of bloody discharge during sexual intercourse.

The initial gynecological examination is performed using a colposcope. Such an inspection is recommended once every six months. During colposcopy, the surface of the cervix is ​​dried and a detailed examination is performed under multiple magnification.

To identify questionable areas, special dyes are used. For example, to identify problem areas and epithelial defects, a 3% acetic acid concentrate is used, under the influence of which inflamed blood vessels experience spasm and turn white.

In the presence of certain types of infections, for example, a highly oncogenic type, a screening test for HPV is prescribed, which recognizes the DNA of the virus.

Treatment of reactive changes in the cervical epithelium

Treatment measures are carried out after a detailed examination of the clinical picture.

Treatment is prescribed depending on the following factors:

• etiology of the inflammatory process
• type of pathology
• planning an upcoming pregnancy
• woman's age

Sanitation of the genital tract is intended to overcome the inflammatory process. The next stage involves restoring the natural microflora of the vagina.

Surgical interventions are performed in cases of cervical dysplasia.

The main methods of treating reactive pathologies:

• Cryodestruction - the epithelium is exposed to liquid nitrogen.
• Diathermocaugulation - cauterization of the damaged area with electric current. A scar subsequently forms on the treated area.
• Chemical coagulation - the surface of the epithelium is treated with chemicals.

Preventive measures

Prevention of cervical pathologies should begin in the first trimester of the prenatal period.

The onset of sexual activity is accompanied by the emergence of reactive pathologies. Gynecological examination, colposcopy and oncocytological studies should be carried out at least once a year.

Apr 17, 2016 Violetta Doctor

When visiting a gynecologist, it is always necessary to take a smear for flora. It can be used to determine the condition of the vaginal mucosa and the presence of infections. Only a doctor who knows the norms of all indicators can decipher a smear correctly. The epithelium in the smear may indicate the presence of an inflammatory process, which may be associated with various reasons.

Indications for the purpose of analysis

There are certain reasons that require a smear test from the vagina or urethra to determine the presence of infections or inflammation in the reproductive system:

• pain localized in the lower abdomen;
• taking antibiotics for a long time;
• the presence of suspicious vaginal discharge that causes discomfort;
• sensation of itching and burning in the genital area;
• pregnancy planning;
• carrying out a preventive examination.

If you have unpleasant symptoms, you should immediately visit a doctor and get a smear and test for the presence of sexually transmitted infections. What epithelium means in a smear depends on the characteristics of its cells and their structure and quantity.

Rules for preparing for analysis

To get a reliable result, you must:

• two days before the smear test, avoid sexual contact;
• do not use vaginal contraceptives (including condoms, ointments, lubricants and creams) and suppositories;
• stop douching two days before the test;
• do not conduct examinations during menstruation, since menstrual blood significantly distorts the test results and may show that the epithelium in the smear is increased; the most correct option would be to take a smear in the first days after the end of menstruation;
• You should not use intimate hygiene products the day before; genital hygiene procedures should be carried out simply with warm water without using any detergents;
• You cannot go to the toilet two hours before taking the test.

Proper preparation for a smear will allow you to most accurately determine the number of cells in it and assess the health of the reproductive system. The epithelium in the smear indicates the condition of the vaginal and cervical mucosa. If the norm changes, one can conclude that there is inflammation or atrophy of the epithelial layer.

Smear technique

A smear for cytology is taken using a special spatula, which is available in a standard gynecological kit intended for examination. It is necessary to take the analysis at the site of transformation (where the squamous epithelium turns into columnar epithelium); after taking the material, it is distributed over a glass slide.

The transformation zone is located in the area of ​​the external pharynx, but in some cases (depending on hormonal balance and age) it can change its position. Taking a smear from the area of ​​transitional epithelium is necessary to accurately determine the presence of malignant cells. Since they appear from the lower layers, taking a smear from the location of the surface epithelium, it will be possible to diagnose cancer only at the last stage.

That is why the epithelium in the smear plays a very important role. The norm in women ranges from 3-15 units in the field of view. If their number is higher, additional examinations need to be carried out to detect a malignant tumor.

What is squamous epithelium and its significance in a smear

The squamous epithelium is the mucous membrane of the vagina. Depending on the phase of the menstrual cycle, cells may undergo minor changes. The surface epithelium is divided into keratinizing and non-keratinizing, the ratio of cells changes in different phases, so it is necessary to take this fact into account in order to determine whether the obtained indicators are normal.

Epithelium in a smear is normal only if its number does not exceed 15 units in the field of view. Exceeding the norm indicates the presence of inflammation or a recent infection. When the structure of cells changes, suspicions arise about the development of a benign or malignant tumor.

The value of columnar epithelium in a smear

The epithelium in the smear, which has a cylindrical shape, is functional, as it ensures the secretion of mucus on the cervix. Normally, the cylindrical epithelium in a smear is represented by groups of cells that have a honeycomb-like or linear structure.

In addition, goblet-shaped cells can be found, their difference is in the cytoplasm stretched with mucus. In some cases, such cells may contain secretion granules. A common pathology, ectopia, is a displacement of the columnar epithelium and its replacement of flat surface epithelium.

Further diagnostic measures

If epithelium is found in the smear, the norm of which is violated, the doctor can diagnose vaginitis. In addition to the high concentration of epithelial cells in the analysis, the woman should have an uncomfortable discharge with an unpleasant odor, itching and pain in the vagina, and redness of the vulva.

Vaginitis is treated with antibiotics, which are combined with antifungal or other drugs, depending on the type of pathogen.

Treatment of non-infectious vaginitis

If the epithelium in the flora smear is increased, and no infections were detected, we can conclude that a non-infectious pathogen is present. These may be hygiene products containing chemicals that cause irritation of the mucous membrane, contraceptives, or with increased sensitivity of the vagina to spermicides.

In these cases, it is enough to stop using the products, and after some time the concentration of epithelium in the smear will itself restore to normal levels. To speed up the effect, you can use suppositories or tablets that normalize the vaginal microflora and allow normal cells to recover faster.

Epithelium in a smear in men

A high content of epithelial cells in the smear can be observed not only in women, but also in men. The most common disease accompanied by an increased amount of epithelium is urethritis. In men, urethritis is accompanied by pain and burning when urinating, a feeling of discomfort and swelling in the genital area and groin, and the appearance of discharge from the penis or blood in the urine and semen.

Female urethritis is accompanied by chills, pain in the lower abdomen, frequent urge to urinate, burning and pain, as well as the presence of atypical vaginal discharge.

Urethritis can be caused by:

• cytomegalovirus;
• herpes simplex virus;
• chlamydia;
• gonococci.

If any virus or bacteria is detected, additional examinations and effective treatment are required.

Atypical epithelial cells in a smear

In some cases, atypical epithelium may be detected in the smear. What does it mean? An altered structure of squamous epithelial cells lining the vagina and cervix may indicate the development of cancerous tumors or dysplasia.

Cervical dysplasia causes cancer in only one percent of women. In other cases, with regular monitoring and treatment, it goes away within a few years. If the disease continues to develop and there is a danger of cancer cells developing, the doctor may recommend a hyperectomy - removal of the uterus and cervix.

Most often, this procedure is performed on women who have reached menopause or women who no longer plan to give birth.

Methods for eliminating atypical cells

If there is a large amount of atypical epithelium, radical methods aimed at destroying cells may be required. After this, the number of cells is normalized, and the epithelium in the smear is restored. The norm for women during the recovery period is individual, so after surgery, after some time you need to visit a gynecologist and take a smear test again.

The following methods are usually used to treat dysplasia:

• Laser therapy is the most modern and effective method. In addition to removing the atypical area, you can also examine its depth and act on all layers of tissue. This procedure is very painful and traumatic, so bleeding may begin after a few days.
• Diathermy - cauterization, is the effect of electricity on an atypical area. It is the fastest and easiest method. After cauterization, scars may remain on the cervix, which in some cases cause the development of infertility.
• Cryothermy is the effect of ultra-low temperatures on the damaged area. The method is effective only in the initial stages of dysplasia. With the development of cancer cells or the occurrence of atypical processes in the cells of the basal layer, it does not produce any results.

All these procedures are aimed at destroying atypical cells under the influence of temperature or a laser beam. In place of the destroyed cells, squamous and cylindrical epithelial cells appear, which are normal for the cervix and vagina.

The epithelium in the smear, the normality of which has been restored after such procedures, will not carry the risk of developing cancer. If the treatment procedures are not effective, it is likely that a hyperectomy (removal of the uterus and cervix) will have to be performed.

The cervix looks like a cylinder, measurements showed that its length is 3 - 4 cm, and its diameter is 2 - 2.5 cm. A normal and healthy appearance of the cervix looks like a smooth pink surface of the mucous membrane and is located 12 cm from the vestibule of the vagina, the thickness of the walls vagina 3-4 mm. The internal genital organs change depending on the menstrual cycle and the woman’s age, but it often happens that the cause of the changes is disease. Cervical hyperkeratosis or leukoplakia is a pathological process that manifests itself in keratinization of tissue. Women after 35–40 years of age are susceptible to hyperkeratosis.

Classification of the disease

Hyperkeratosis of squamous epithelium of the cervix

This is keratinization of epithelial cells. White film, clear boundaries, which cannot be removed mechanically. With hyperkeratosis of the MPE (stratified squamous epithelium) of the cervix, all layers are affected: the basal, parabasal, intermediate, and superficial layers. Both part of the mucosa and the entire epithelial layer of the cervix are susceptible to tissue destruction.

Focal hyperkeratosis

This is a serious deficiency of female hormones. It looks like clearly defined white spots with a matte sheen on the cervix. This condition is also called pseudo-erosion.

Parakeratosis of the cervix

One of the pathological processes is parakeratosis. This is a change in the mucous layer, a violation of keratinization of the lining of the organ. It is much less common than hyperkeratosis of squamous epithelium. It occurs as a result of injury to the internal genital organs of a woman during rough sex, as well as during medical procedures: installation of a spiral, cleaning, abortion. With parakeratosis, a tissue cell ceases to produce keratohyalin, which is responsible for the elasticity of the epithelial layer, so the mucous membrane is more susceptible to damage and injury.

Dyskeratosis

It differs from other species in that the cells divide chaotically at a high speed, the neoplasms grow and become similar in appearance to cauliflower, which grows on the epithelial layer. Since exfoliation of keratinized cells does not occur, scale by scale they form layers - the size of the neoplasms becomes impressive. Dyskeratosis is dangerous because uncontrolled growth of tumor cells can occur in a short period of time. Human papillomavirus (HPV) and HIV infections are important; they increase the risk of cells degenerating from benign to malignant.

Danger

The disease poses a threat to the health and life of women. If focal keratosis is not detected during the procedure, the consequence is cervical atrophy. The estrogen hormone is reduced, the epithelium is suppressed, the tissue is smoothed out. Atrophic vaginitis is a common phenomenon. Postmenopause is one of the reasons. Often occurs against the background of cancer pathologies. The most recognizable symptoms are intermittent bleeding, as well as vaginal dryness, and a constant urge to urinate.

Cervical atrophy causes infertility and cervicitis, which is characterized by purulent discharge, pain during intercourse and urination. The uterine pharynx and vagina have an inflammatory process that is often neglected. If a couple wants to have a child, then first it is necessary to cure cervicitis, otherwise the child may be born with developmental disabilities.

But the most dangerous is dyskeratosis. Over a short period of time, uncontrolled growth of tumor cells can occur. Human papillomavirus (HPV) and HIV infections are important; they increase the risk of cells degenerating from benign to malignant.

Signs of cervical hyperkeratosis and diagnosis

The anomaly as a whole occurs without any symptoms, almost without manifesting itself. The woman’s condition is satisfactory, so diagnosis of keratosis occurs during a visit to the doctor for a routine medical examination. But still, some signs of leukoplakia exist. If an infectious disease of the reproductive system provokes hyperkeratosis, then the following may occur:

• vaginal itching, burning;
• discharge with an unpleasant odor;
• discomfort and pain during or after sexual intercourse.

During the examination, the female doctor discovers damage to the cervical mucosa in the form of white plaques. A whitish coating is localized in the vaginal part, in the vulva area. Gynecology identifies several forms of this disease:

• flat or simple;
• verrucous or verrucous.

If flat leukoplakia is not treated promptly, the pathology degenerates into a warty form and looks like a lumpy lesion of the white mucosa.

Diagnosis

To determine the type of leukoplakia, a number of examinations are carried out. A biopsy, ultrasound, smear for oncocytology and smear examination for histology will most fully reflect the clinical picture. Elements of hyperkeratosis are atypical cells that can develop progressively and turn into cancer. The treatment strategy directly depends on the identified form.

Causes of the disease

Statistical tables show that the popularity of vaginal keratosis among women is growing.
Factors of pathological mutations are:

Treatment

Therapy for keratosis is prescribed individually and depends on the degree of damage to the mucous membrane, localization, and cytology results.

Medication method

Taking medications restores the epithelium and these drugs include:

• pre- and probiotics;
• hormones;
• immunostimulating;
• anti-inflammatory drugs;
• macro- and microelements, vitamins;
• antibacterial agents;
• antiviral drugs.

Surgical method

But in most cases, the problem is solved by surgical intervention:

• diathermocoagulation – thermal cauterization with electric current;
• chemical coagulation - cauterization with acids: “solkovagin” and “vagotil”;
• electroconization – removal using an electric loop;
• laser therapy – the therapeutic use of laser light;
• therapy is the most highly effective and minimally painful method, in which removal occurs using an electrode with high-frequency waves;
• knife conization - removal of fragments with a scalpel;
• cryodestruction – exposure of the lesion to extremely low temperatures;
• amputation - an organ is removed.

To avoid scars, young women undergo:

• radiosurgical treatment;
• laser vaporization;
• cryo destruction.

It is very important to eat right during treatment. The rate of vitamin A intake is one of the important conditions: pork and beef liver, cheese, cottage cheese, cream, egg yolk, cod or halibut fish oil, also medical. Beta-keratin is found in carrots, pumpkin, apricots, greens and black currants, and the body independently synthesizes retinol from it. It is necessary to remove hot, spicy, salty foods from the diet. To strengthen the immune system, vitamins contained in vegetables and fruits are necessary. Additionally, sexual rest, abstinence from alcohol and smoking, proper rest, and proper hygienic care are prescribed for 4–8 weeks.

A mild degree of leukoplakia does not affect the ability to get pregnant. If the disease has reached a severe stage, then the decision on treatment is made by the doctor individually after examination.

In the case of leukoplakia discovered during pregnancy, there is no need to panic. First of all, you need to take the recommended tests: blood, a smear, a section of the cervix for histology, circicometry, and the abdominal cavity is examined using an ultrasound machine. Keratosis of the cervix is ​​not a reason to terminate a pregnancy. An indication for abortion may be rapidly progressing cancer, and even in this case the week of pregnancy plays a role. Basically, experts insist on continuing the pregnancy. The fetus is regularly monitored for the disease.

Drug treatment is selected depending on the trimester; if therapy is unsuccessful, then surgery occurs after childbirth. If the focus of whitish spots is small, then they can disappear without any drugs or medical procedures, on their own.
Women often get scared when they hear a diagnosis, so they immediately want to read information on the Internet about who had it and how they managed to overcome the disease. A forum where the female sex often finds communication can persistently advise folk remedies.

IMPORTANT! Since leukoplakia is considered a precancerous condition, any experiments can be harmful. Before resorting to traditional medicine, you should definitely consult a doctor. Doctors warn that douching with decoctions of medicinal herbs will not only not bring any improvement, but will also worsen the situation and activate the biotransformation of cells. Not so long ago, when treating hyperkeratosis using folk methods, tampons with sea buckthorn, olive or sunflower oil and douching with decoctions of various herbs were often used. To date, scientists have proven that such manipulations do not bring improvement, but only aggravate the situation and transform cells from benign to malignant.

Hyperkeratosis is no joke. The disease is very serious. To avoid leukoplakia, you need to treat even minor diseases in time, do not expose the internal genital organs to injury (coils, abortions), maintain proper hygiene and do not forget to check with a gynecologist every six months.

Video: What is cervical leukoplakia? (hyperkeratosis)

Video: Leukoplakia of the cervix