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Treatments If you have mild abnormalities or CIN1, you may not need treatment and instead will be asked to come back for another smear in a few months’ time. If you have moderate or severe changes (CIN2 or CIN3), however, you may be advised to have treatment. You may be offered treatment at your first colposcopy visit or you may have a separate appointment after colposcopy. Treatment involves either removing or destroying the abnormal cells while causing as little damage as possible to surrounding healthy tissue. The type of treatment you are offered depends on the results of your colposcopy and biopsy, and the facilities available at your hospital or clinic. All of the treatments for abnormal cells are extremely effective and most are done on an out-patient basis which means you can go home after treatment. If possible, arrange for someone to either come with you or pick you up afterwards. |
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LLETZ/LEEP The most common treatment for removing abnormal cells is called LLETZ (large loop excision of the transformation zone). It’s also known as loop diathermy or LEEP (loop electro-surgical excision procedure).  LLETZ is used for both diagnosing and treating abnormal cell changes and may be performed at your first visit for colposcopy. It takes about 5 to 10 minutes and is usually done under local anaesthetic. The doctor uses the colposcope to see a magnified image of your cervix and then, with a thin wire loop, cuts out the abnormal tissue. The loop is heated with an electric current, which cuts and seals the tissue at the same time. To ensure the electric current has a safe return path – and that it does not injure you – a sticky electrode is placed on your thigh before treatment. This may sound alarming but the procedure is very safe. LLETZ is not usually painful because of the local anaesthetic, however some women describe feeling a sharp period pain or a burning sensation. If you are worried about the pain, ask the doctor for a painkiller before the procedure. Aspirin is not advised because it may increase bleeding, but you may be given ibuprofen or paracetamol. The cut-out tissue will be sent for analysis to make sure all of the abnormal cells have been removed. If the cells on the outer edge of the sample are normal, you won’t need any more treatment. If there are abnormal cells along the edge, however, it may mean there are still some cell changes on your cervix and you will need another colposcopy to check. Laser therapy Laser treatment destroys abnormal cells by vaporising them with a hot beam of light. The procedure takes 5 to 10 minutes and before treatment you will be given a local anaesthetic to numb your cervix. You may still feel some pain during treatment and some women find the slight burning smell distressing. There will also be a machine in the room that extracts the smoke created by the vaporising tissue, and it may cause a lot of noise during treatment. Cold coagulation Despite its name, cold coagulation uses heat to destroy abnormal cells. The procedure takes just a few minutes and is usually done under local anaesthetic. This helps to numb your cervix, but you may still feel a slight period-like pain during treatment. The doctor places a hot probe on your cervix for about 30 seconds to burn away any abnormal tissue. To a large extent, cold coagulation has been replaced by LLETZ. Cryosurgery/cryotherapy Cryosurgery destroys abnormal cells by freezing them. The procedure may take up to 15 minutes and you will be given a local anaesthetic in your cervix. The doctor then places a very cold probe on your cervix and holds it there for two to three minutes. She or he may repeat the process a second time to make sure the cells are destroyed. Cryosurgery is not as effective as other treatments for cervical cell changes and is not commonly used. Cone biopsy Cone biopsy surgically removes the affected area either with a knife or laser, and may be used both to diagnose and treat cell changes. See cone biopsy for more information. Hysterectomy Hysterectomy surgically removes a woman’s womb and cervix. It should only be recommended for women who have recurrent abnormal smears or severe cell changes who also are past the menopause or have other gynaecological health issues, such as fibroids or heavy bleeding. Hysterectomy is a major operation and you will be in hospital for about a week. For more information, see the Women’s Health online hysterectomy leaflet. After treatment  If you’ve had LLETZ, laser therapy, cold coagulation or cryosurgery, you will be able to go home as soon as your treatment is finished, but it may take 4 to 6 weeks before your body is completely recovered. Pain – you may have period-like pains for about a day following treatment, but an over-the-counter pain medication may help. Ask the doctor or nurse if there are any medications you should not take. Rest – you may feel fine after a day or two, but take it easy for about a week to help your body heal. Don’t lift heavy objects or do strenuous exercise and get as much rest as you need. Bleeding and discharge – you may be given a prescription for antibiotic cream to put in your vagina for a few days after treatment. Make sure to get this filled at the hospital or chemist before you go home. You should expect to have light bleeding and a vaginal discharge for at least a few days and as long as four weeks. If you had cryosurgery, you may have a lot of watery discharge. If the pain, bleeding or discharge gets worse rather than better, you may have an infection and should contact your doctor. Note: after treatment you may get your next period earlier than expected and it may be heavier then usual. Don’t use tampons during this period. Getting better – your cervix will need time to heal, so don’t use tampons, douche or have sexual intercourse until bleeding or discharge has stopped. This may vary from woman to woman but is generally about 3 to 4 weeks. If you have a follow-up appointment to check that your cervix is healing properly, this is a good time to raise any questions or concerns you have about the healing process and when you should have your next smear test. You may be advised to have a follow-up smear in six months and, if those results are normal, every year for a few years. Follow-up recommendations vary so ask your doctor what to expect. |
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Written by Tamara Beus and published in printed format (2003) by Women's Health
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