Cervical Dysplasia Symptoms, Causes, Treatment

Cervical Dysplasia (cont.)

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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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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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