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February 10, 2012

Cervical Dysplasia (cont.)

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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.


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