Test-and-treat

The aim of treatment is to destroy or remove any abnormal cells that are present in the cervixAny neck-like structure; most commonly refers to the neck of the uterus., allowing healthy cells to replace them over time. With the exception of cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic. (also known as conisation), all the treatments below can be performed under local anaestheticA medication that reduces sensation in a part of the body., during the same visit as the colposcopyClose examination of the cervix of the uterus using a magnifying instrument with attached light source, known as a colposcope..

Large loop excision of the transformation zone

Despite its rather long name - often abbreviated to LLETZAn abbreviation for large loop excision of the transformation zone, a type of surgery used to cut out abnormal tissue of the cervix of the uterus. It uses a loop of heated wire that acts like a scalpel. and also known as loop electrosurgical excisionThe removal of a piece of tissue or an organ from the body. procedure (LEEPAn abbreviation for loop electro-surgical excision procedure, a type of surgery used to cut out abnormal tissue of the cervix of the uterus. It uses a loop of heated wire that acts like a scalpel.) - this is a simple procedure that usually takes just five to ten minutes.

The transformation zone is the area of the cervixAny neck-like structure; most commonly refers to the neck of the uterus. where CIN can arise. As suggested by the name, a heated wire loop can be used to remove this area when abnormal cells are identified; the heat also seals the wound.

You may bath or shower the day after the loop procedure, but you will be advised not to have sexual intercourse or wear a tampon for 4 weeks

This procedure is sometimes done on the same day as the colposcopy. It can cause pain similar to period pain and there can be light bleeding or discharge for several weeks afterwards. You should call your clinic, however, if you experience bleeding that is heavier than your normal menstrual period, if you get severe abdominal cramps or if you have a high temperature.

You may bath or shower the day after the procedure, but you will be advised not to have sexual intercourse or wear a tampon for 4 weeks, to lower any risk of infectionInvasion by organisms that may be harmful, for example bacteria or parasites..

Cryotherapy

This involves freezing the abnormal cells of the cervixAny neck-like structure; most commonly refers to the neck of the uterus.. Sometimes a brief, cold sensation is felt during the procedure. You may experience period-like pain during treatment and for a short while afterwards,and it is normal to have a watery discharge for 2 to 4 weeks.

Laser treatment

Laser therapy can be used to destroy abnormal cells or to remove a small piece of the cervixAny neck-like structure; most commonly refers to the neck of the uterus. itself. As it is performed under local anaestheticA medication that reduces sensation in a part of the body., you should not feel any discomfort but you may note a slight burning smell, as the abnormal tissue is burnt away. This is perfectly normal.

Cold coagulation

Here, a heat source is used to burn away any abnormal cells. The name is misleading. As with cryotherapyA therapy that destroys unwanted cells or tissue by freezing it., above, you may have a period-like pain during the procedure and for a little while afterwards.

Cone biopsy

A cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic., sometimes also called conisation, is so named because it involves the removal of a cone of tissue containing the abnormal cells. It is a minor operation that is usually, although not always, performed under general anaestheticAny agent that reduces or abolishes sensation, affecting the whole body., and so typically involves an overnight stay in hospital.

You will be advised to rest for 2 to 4 weeks after the cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic.; you do not need to stay in bed, but you should avoid heavy lifting and vigorous exercise

If the procedure is performed under general anaestheticAny agent that reduces or abolishes sensation, affecting the whole body., you may be asked not to eat or drink for six hours beforehand.

Sometimes a gauze pack will be placed in your vagina afterwards to help to stem bleeding, and you may need a catheterA tube used either to drain fluid from the body or to introduce fluid into the body. for a short time. If this is the case, both the pack and the catheterA tube used either to drain fluid from the body or to introduce fluid into the body. will be removed by your doctor or nurse before you leave the hospital the next day.
You may have period-like pain and a discharge or minor bleeding for up to 4 weeks. Some scientific studies have shown that taking tablets of tranexamic acid after a cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic. can help to reduce bleeding, although this is not routinely recommended.

You will be advised to rest for 2 to 4 weeks afterwards; you do not need to stay in bed, but you should avoid heavy lifting and vigorous exercise. You will also be advised not to have sexual intercourse or use tampons in the first 4 to 6 weeks, to allow the cervixAny neck-like structure; most commonly refers to the neck of the uterus. to heal fully.

You may not be able to drive for 1 week after the cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic.. Your doctor will advise you on this and it may be helpful to check your insurance policy as well.

Possible risks and complications of having a cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic. include bleeding and infectionInvasion by organisms that may be harmful, for example bacteria or parasites.. If you become pregnant after having a cone biopsyThe removal of a cone-shaped section of tissue from the cervix of the uterus, which is then sent to a laboratory for examination; this may be curative as well as diagnostic., there is a slightly increased risk of premature birth. It is important to discuss this with your doctor because there are steps that can be taken to reduce this risk.

See the quick guide on Biopsies.