Types of Treatment

Cryocautery

A probe is applied to freeze an area on the cervix. It is an excellent method for treating bleeding after intercourse or persistent heavy vaginal discharge. It is also good for treating persistent CIN 1 in which all the area of abnormality can be seen on the cervix during a colposcopy examination. It is carried out in the colposcopy clinic and no anaesthetic is needed. Women will get a heavy watery discharge for several weeks after cryocautery as the cervix heals. For more information see our Cryocautery leaflet.

Excisional Treatments

The types are - Large Loop Excision of Transformation Zone (LLETZ), Laser Cone and Needle Excision of Transformation Zone (NETZ). These all involve cutting out the area on the cervix to remove the abnormal cells, either using a loop, needle or laser. LLETZ is most often used at the Whittington hospital and it is carried out in the colposcopy clinic using local anaesthetic. LLETZ can also be done in the day treatment centre under sedation or general anaesthetic. Laser cone and NETZ are currently only done in the day treatment centre. What type of excisional instrument used and whether it is performed using only local anaesthetic, or under sedation or general anaesthetic depends on the area on the cervix that needs to be removed and what the women wants. Each procedure usually only takes 15-30 minutes.

LLETZ under local anaesthetic you can attend your appointment with someone if you want to. The speculum will be inserted and the fluid washed over the cervix again, the same as the colposcopy examination. Local anaesthetic will then be given and then a loop will be used to remove the abnormal area. For more information please read our Excisional treatment for abnormal cells on the cervix (colposcopy clinic) leaflet.

Excisional treatment under sedation or general anaesthetic will mean you need to attend for a medical check-up with a nurse to ensure you are fit for surgery first. This is standard procedure but if you do not attend the treatment will be cancelled. Before you attend for the treatment you must not eat anything for six hours before your operation. Once prepared for the day treatment centre you will be taken to the operating theatre and either given general anaesthetic or sedation. The procedure is then carried out the same as if you were awake. For more information please read our Excisional treatment for abnormal cells on the cervix (day treatment centre) leaflet.

Laser Vaporisation

Carried out in the day treatment centre under local, sedation or general anaesthetic. This involves using a laser to vaporise and destroy abnormal cells on the cervix or the vagina. This is a similar procedure to the excisional treatment where by you will need a medical check first and nothing to eat six hour before your treatment. Once again you will be taken to theatre, speculum inserted, fluids put on the cervix and the vagina and then the laser will destroy the abnormal area. For more information please read our leaflet Laser vaporisation in the day treatment centre.

After any of the treatments under sedation or general anaesthetic most women go home the same day and just need someone with them for 24 hours to ensure you are ok. Having treatment under local anaesthetic, most women have the day off work but can then return to work the following day. After having sedation or general anaesthetic you will need approximately 5 -7 days off work to recover.

Risks and complications of the treatment are very small

After the treatment you will experience some bleeding or messy discharge as your cervix heals. Some days can be as heavy as a period. This can last up to 4 weeks and during this time please do not use tampons, have sexual intercourse or go swimming to reduce the risk of getting heavy bleeding or an infection. If you have concerns please contact us, see your GP or attend A+E if this is over the weekend or a bank holiday.

Excisional treatments have a small risk (2%) of causing closure of the cervix. Those most at risk of this rare complication are women having infrequent or no periods. You can discuss this with the colposcopist before your treatment. If you have any concerns after your treatment please see your GP or contact us.
 
The other small risk of excisional treatment is preterm labour (4 -5 %) in future. If you have this form of treatment it is important to advise your GP and midwife once you become pregnant that you have had this treatment carried out. You can discuss this with the colposcopist before your treatment. If you have any concerns after your treatment please see your GP or contact us.

Treatments to the cervix and vagina are to remove or destroy the abnormal cells to prevent them from progressing in future. 95% of women who undergo treatment will have their follow-up smear return to normal. For the remaining 5% some further treatment may be necessary at a later stage. After your treatment your will receive a results letter in 4- 6 weeks time and/ or information on booking a follow-up appointment. Follow- up appointments are usually 6 months after your treatment where you will have a smear test, testing for abnormal cells and high risk HPV (Test of Cure) . If these are both negative you can safely be discharged back to your GP. If either the smear test or HPV test are positive you will be called back for a colposcopy examination. Some women will receive a phone call and an appointment date to discuss their results sooner than the 4 6 weeks results letter.

If you have treatment for CGIN you will have follow-up colposcopy appointments for 5 years in the colposcopy clinic.
Page last updated: 22 Jun 2022
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