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.
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.
What should a patient expect from each of the treatments for cervical abnormalities?
Carbon dioxide laser photoablation
This procedure, which is also known as CO2 laser, uses an invisible beam of infrared light. The laser actually vaporizes the abnormal area. Lidocaine, a local anesthetic, is given to numb the area prior to the laser treatment. A chemical is applied afterwards to prevent delayed bleeding. A substantial amount of clear vaginal discharge and spotting of blood can occur for a few weeks after the procedure. To improve healing, sexual intercourse and tampon use should be delayed for several weeks.
The complication rate of this procedure is very low, about 1%. The most common complications are narrowing (stenosis) of the cervical opening and delayed bleeding. Disadvantages of this treatment include that this procedure does not allow sampling of the abnormal area and is not satisfactory for treating cervical cancer. It is useful, however, for milder dysplasia. It is generally not considered safe for use during pregnancy.
Cryocautery
Cryocautery is a relatively simple procedure that 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, patients can experience a significant watery vaginal discharge for
several weeks. To improve healing, sexual intercourse is best avoided for
several weeks.
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 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.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Cervical cancer is cancer of the entrance to the womb (uterus). Regular pelvic exams and Pap testing can detect precancerous changes in the cervix. Precancerous changes in the cervix may be treated with cryosurgery, cauterization, or laser surgery. The most common symptom of cancer of the cervix is abnormal bleeding.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Cervical dysplasia is a condition in which the cells of the inner lining of the cervix have precancerous changes. There are two types of cervical dysplasia; 1) squamous intraepithelial lesion, and 2) cervical intraepithelial neoplasia. Cervical dysplasia is caused by infection of the cervix with HPV (human papillomavirus). There are various diagnostic measures for cervical dysplasia. Treatment generally depends upon the progression of the dysplasia, mild, moderate, or severe.
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the U.S. HPV is primarily transmitted by sexual contact. While some people develop warts in the genital region after infection, others experience no symptoms. Though genital warts can be removed, there is no cure for HPV infection. There is a vaccine to prevent infection from four common HPV types.
Vaginal cancer is fairly uncommon. There are two types of vaginal cancer: squamous cell carcinoma and adenocarcinoma. Risk factors include being 60 or older, exposure to DES while in the womb, HPV infection, and having a history of abnormal cervical cells. Painful intercourse, pelvic pain, vaginal lumps, and abnormal vaginal bleeding or discharge are all symptoms of vaginal cancer. Treatment depends upon the stage of the vaginal cancer and may involve surgery, radiation therapy, chemotherapy, and the use of radiosensitizers.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
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