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November 25, 2009
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Colposcopy (cont.)

Loop electrosurgical excision procedure

Loop electrosurgical excision procedure, also known as LEEP, uses a radio-frequency current to remove abnormal areas. It has an advantage, therefore, over the destructive techniques (CO2 laser and cryocautery) in that an intact tissue sample for analysis can be obtained. LEEP also is popular because it is inexpensive and simple. A chemical is applied afterwards to prevent bleeding. Vaginal discharge and spotting commonly occur after this procedure. Sexual intercourse and tampon use should be avoided for several weeks to allow better healing.

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. LEEP also is used, although infrequently, to treat carefully chosen cases of cervical cancer.

Cold knife cone biopsy (conization)

Cone biopsy was once the major 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 continues to be recommended. It is also recommended if special sampling is needed to obtain more information regarding certain types of more advanced abnormalities. This technique allows the size and shape of the sampling to be tailored.

Complications of this procedure include postoperative bleeding in 5% of women and narrowing of the cervix. Cone biopsy has a slightly higher risk of cervical complications than the other treatments. This procedure is occasionally used to treat carefully chosen cases of cervical cancer.

Hysterectomy

Hysterectomy is the surgical removal of the uterus. This operation is used to treat virtually all cases of invasive cervical cancer. Sometimes, a hysterectomy is done to treat severe dysplasia. It is also used if dysplasia recurs after any of the other treatment procedures.



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