Treatment
for CIN Many people think that treatment
for CIN involves LASER. In fact, LASER is used little nowadays
and has been superseded by more modern techniques such as
diathermy excision. This is sometimes called LLETZ (Large
Loop
Excision
of the Transformation
Zone)
or LEEP (Loop
Electrical
Excision
Procedure).
Other methods also exist such as something called Cold Coagulation,
however, this leaflet concentrates on LLETZ which is the most
common method of treatment.
Why do I need treatment?
The main reason for performing treatment is to remove an area
of cells with an abnormality called CIN. CIN stands for Cervical
Intraepithelial
Neoplasia
which in layman’s terms might translate as Cervix
In-the-skin
New-cells.
These are abnormal cells that exist in the cervix due to changes
caused by the wart virus. If left untreated, the CIN cells
might turn intocancer.
Not all CIN cells need treatment but only those that are not
mild or which have persisted. The CIN cells might have been
detected firstly by the smear test and then confirmed during
a colposcopy examination and possibly a biopsy.
Where does treatment
occur?
Treatment usually occurs as an outpatient (in the clinic).
Occasionally, women who find the colposcopy examination particularly
uncomfortable and other women with pre-existing conditions
need treatment under general anaesthetic.
What happens during treatment?
A colposcopy examination is performed in the same manner it
was previously (see leaflet on colposcopy). Once the gynaecologist
has decided which area of the cervix should be removed, local
anaesthetic is injected. This is very fast acting and sometimes
makes you feel a little light headed. If LLETZ is used, a
suction device is then turned on and treatment is performed.
The whole procedure usually takes less that 15 minutes.
What are the complications?
Treatment for CIN is generally very safe. Very few complications
exist but some important problems can occur. Some women bleed
excessively following treatment. In very rare circumstances
this can be so severe that a woman requires admission to hospital
and administration of a blood transfusion. However, this is
very rare. Bleeding can occur late after treatment as bacteria
that live naturally in the vagina cause vessels to open up.
If this occurs, women sometimes need additional measures to
stop the bleeding.
Older methods of treatment were sometimes complicated by conditions
known as ‘cevical stenosis’ and ‘cervical
incompetence’. It is controversial as to whether these
complications exist or not with newer forms of treatment.
It is probable that they can exist, but only extremely rarely.
Cervical incompetence is a condition associated with repeated
miscarriage in pregnancy. Cervical stenosis is when the neck
of the womb blocks off preventing women from having periods.
Cervical stenosis can also cause infertility and pain. These
complications are so rare that they are always outweighed
by the risks of not having treatment for CIN.
What is the success
rate?
Ninety five percent of women are cured following their first
treatment. Some women need continued surveillance for minor
abnormalities following treatment and others need repeated
treatment. It is important you have the follow-up smear tests
that you are recommended.
What should I do after treatment?
It is recommended that women do not return to work on the
day of treatment but most women can return to work the next
day. If you have bleeding which is worse than the worse day
of your worse ever period then you need to see a doctor as
an emergency. You should contact your gynaecologist or present
to a hospital casualty. You should refrain from sex for four
weeks following treatment because of the risks of bleeding
complications.
Follow-up appointments?
The frequency of follow-up appointments depends on the abnormality.
After treatment for CIN it is normal to require at least one
follow-up appointment after treatment. If you have been discharged
from the colposcopy clinic, you may require smears more frequently
than you had them before. You should always ensure that you
know when your next smear test should be afterwards.
