Cervical Dysplasia (cont.)
Cryocautery
Like the laser treatment, cryocautery is an ablation
therapy. It uses nitrous oxide to freeze the abnormal area. This technique,
however, is not optimal for large areas or areas where abnormalities are already
advanced or severe. After the procedure, women may experience a significant
watery vaginal discharge for
several weeks. As with laser ablation, significant complications of this
procedure are rare and occur in about 1% of patients. They include narrowing
(stenosis) of the cervix and delayed bleeding. Cryocautery also does not allow
sampling of the abnormal area and is generally felt to be inappropriate for
women with advanced cervical disease. Thus, this procedure is not satisfactory
for treating cervical cancer, but is useful for milder dysplasia.
Loop electrosurgical excision procedure
Loop electrosurgical excision procedure, also known as
LEEP, is an
inexpensive, simple technique that uses a radio-frequency current to remove
abnormal areas. It has an advantage over the destructive techniques in that an
intact tissue sample for analysis can be obtained. Vaginal discharge and
spotting commonly occur after this procedure. Complications occur in about 1% to
2% of women undergoing LEEP, and include cervical narrowing (stenosis) and
bleeding. This procedure is used most commonly for treating dysplasia, including
severe dysplasia.
Cold knife cone biopsy (conization)
Cone biopsy (conization) was once the
primary procedure used to treat cervical dysplasia,
but the other methods have now replaced it for this purpose. However, when a
physician cannot view the entire area that needs to be seen during colposcopy, a
cone biopsy is typically recommended. It is also recommended if additional
tissue sampling is needed to obtain more information regarding the diagnosis.
This technique allows the size and shape of the sampling to be tailored. Cone
biopsy has a slightly higher risk of cervical complications than the other
treatments, and these can include postoperative bleeding in 5% of women and
narrowing of the cervix.
Next: Hysterectomy »
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