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During or after colposcopy, you may be offered treatment for cell changes (abnormal cells).
It may be difficult to deal with being told you have cell changes and need treatment. Understanding what treatment involves can be overwhelming, but we hope the information on this page helps prepare you and answers some questions.
Remember, our support services are also here for you. Sometimes it can help just to hear from someone who has been through a similar experience, so you may want to call our Helpline on 0808 802 8000 or join our forum.
If you need treatment and didn’t have it at your first colposcopy, you should be invited for it within 4 to 6 weeks. Your colposcopist should be able to help with any questions or concerns about timeframes.
Treatment depends on the type and grade of the cell changes.
Common treatments for cell changes are:
Other treatments for cell changes are laser therapy, cold coagulation (also called thermoablation) and cryotherapy.
Deciding on treatment can be a really personal thing, so before making decisions make sure you understand:
Your colposcopist should explain all of this. If they don’t, or you feel like you need more information, you can take the time to gather everything you need. We may be able to help with this if you give our Helpline a call on 0808 802 8000 or submit a question to our Ask the Expert service.
Preparing for treatment can be tough and you may feel many emotions, from relief at having treatment, to anxiety about needing it, or confusion about what it involves.
Before treatment, you may be especially worried about:
All your concerns, including any we don’t mention here, are valid. Many people feel this way and it’s important you get the support you need. Talk to your healthcare team, including colposcopist or GP, as well as to support organisations like us.
LLETZ is the most common treatment for removing cell changes. It uses a thin wire loop with an electrical current to remove the area of the cervix where there are cell changes.
You usually have LLETZ as an outpatient. This means you have it in an examination room at a hospital, but can go home afterwards.
Like during cervical screening (smear test), your colposcopist will gently put a new, clean speculum into your vagina.
Your colposcopist will inject a local anaesthetic into your cervix. This means you are awake, but the area that needs treating is numb (you can’t feel it). The injection might sting for a short time.
Your colposcopist will also put a sticky pad on your leg. This makes sure the electric current doesn’t shock you or the colposcopist.
Once your cervix is numb, your colposcopist removes the area of the tissue with cell changes with the loop. It’s normal to notice a slight burning smell and hear a noise like a soft vacuum cleaner. The loop cuts the tissue and seals the cut at the same time. This should not be painful, but you may feel some pressure.
The removed area is sent to a laboratory to test:
If you have cell changes up inside your cervical canal (CGIN), you will need a deeper treatment to diagnose and remove abnormal cells there. You may be offered:
SWETZ and NETZ are similar to LLETZ, but the thin wire is straight, rather than a loop. Depending on the results and your situation, you may need another excision or be offered a hysterectomy. If this happens, your colposcopist will talk through all the options with you.
A cone biopsy is a small surgery that will remove a cone-shaped piece of tissue from your cervix.
A cone biopsy is done under general anaesthetic, which means you are asleep and won’t feel anything. The treatment takes about 15 minutes. Afterwards, you may have to stay in hospital overnight.
A cone biopsy can be done with a:
After a cone biopsy, your doctor may put a small pack of gauze (like a tampon) in your vagina to stop bleeding. You may also have a tube (a catheter) to drain urine from the bladder while the gauze pack is in place. The gauze and tube are usually removed within 8 hours. Once they have been removed, you can go home.
The cone-shaped piece of tissue is sent to a laboratory to test:
Other treatments for cell changes include:
Before any of these treatments, you will usually have a local anaesthetic. This means you are awake, but the area that needs treating is numb (you can’t feel it). The injection might sting for a short time.
These treatments are not used as often. You have them as an outpatient, which means you have them in hospital, but can go home afterwards.
Treatments for cell changes:
However, as with all treatments, there are some possible risks:
After LLETZ or cone biopsy, there is a small chance that the cervix will narrow . If this happens, the passage between the womb and vagina can become partly or fully blocked. This is called cervical stenosis.
Cervical stenosis is more likely if:
If you are worried about cervical stenosis or think you may have it, speak with your GP. They can offer support and practical ways to help, like using a thin tube (dilator) with lubricant to help open the cervix.
After LLETZ or cone biopsy, there is a slightly increased risk of miscarriage and giving birth before 37 weeks (prematurely).
At first, this can sound alarming, but it’s important we try to understand exactly what is meant by this increased risk. In real numbers, after treatment about 2 in every 100 women (2%) will give birth prematurely. When we talk about premature births, in most cases we are talking about births between 32 and 37 weeks – so not severely premature.
The level of risk will depend on:
However, the following is accepted:
Most LLETZ and cone biopsy treatments remove less than 10mm of cervical tissue.
If you are planning on having children, it can be really worrying to read about these slight increased risks. It may help to remember that your healthcare team – both before and during any pregnancy – are there to support you and make sure you have the right care. You may want to speak with your colposcopist before treatment about any concerns, so they can answer your questions and give you support.
If you get pregnant in future, it is important to tell your midwife that you have had LLETZ. They may offer to do an ultrasound scan of your cervix. If they think it is short and there is a risk you may have the baby a bit early, they may offer you a cervical stitch (cervical cerclage). This is an operation where a stitch is placed around the cervix. It is usually done between 12 and 24 weeks of pregnancy, although it may be done later.
If you are worried, it may help to speak with your colposcopist or midwife. They will be able to answer your questions and offer any support you need.
As well as leaning on your colposcopist, we are here to answer your questions and talk through any concerns you have:
After treatment, you may feel worried about what will happen next. This is common and it can help to prepare yourself for any side effects of treatment and the next steps.