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What treatment for CIN2?

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Rb1926
What treatment for CIN2?

Hi 

I had my biopsy results today " a pre cancerous change (CIN2) that may require surgery . 

I have an appointment to discuss and maybe have treatment on the 23rd . It says I may wish to bring someone to drive me home and it will be done under LA so it seems I will be having treatment . At my appointment the doctor told me the letter would say what it has said and told me that the appointment would discuss leaving the cells or treatment in one of 2 ways ( I'm choosing treatment ) one she explained I'm pretty sure is the lletz but the other I have no idea ... I'm sure she said it involved removing 3mm off my cervix . I can't find anything online that sounds like this - a cone biopsy seems to involve removing something but I've read this is under GA and I've been told LA in the letter .

 

This was before she even looked down there so I don't know if it still applies . just wondered if anyone had any idea ? 

23/03/20 - smear result - hpv positive . All previous smears clear. 

09/02/21 - smear result - hpv positive + high grade ( moderate ) dyskaryosis. Referred for colposcopy. 

16/02/21- colposcopy and biopsy . Awaiting results 3-4 weeks . 

04/03/21 - biopsy results in , CIN2 confirmed . Treatment booked for 23/03/21

Lemon Lavender

Hi Rb, 

 

I'm guessing it could by diathermy ablation or perhaps cryotherapy. I was, sent an NHS treatment booklet before my appointment. I'll dig it out tomorrow and see if I can upload pics. 

11/1 Routine smear

26/1 LLETZ 

16/3 MDT - Biopsy sent for further tests

Diary of experience: https://www.jostrust.org.uk/forum/cervical-screening-smear-test/what-were-your-waiting-times

Lemon Lavender

Hi lovely, 

 

I thought I'd be able to upload an image of the leaflet but I can't so I'll use the Google translate app to get the text from each image (page of the leaflet I was given) and you can take a look. I'm sorry the formatting will likely be horrendous, but I hope it helps. Also, although it states 4 weeks for swimming etc, I was told to wait 6 weeks, so do clarify that X

 

NHS Trust TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Colposcopy procedures and treatments An information guide 7 Health & care information you can trust Certified Member  Information Standard

 

 

Colposcopy procedures and treatments procedures , and prepare you for when you attend the colposcopy The aim of this leaflet is to help you understand more about the clinic Punch biopsy to the cervix What is a biopsy ? During your colposcopy , the doctor or nurse may take a small sample of the tissue from the neck of the womb , this is sent to the laboratory . If there are any abnormal changes identified then you may require one of the treatments detailed below . What should I expect after a biopsy ? the biopsy procedure may cause mild cramping , brief pain , and some slight bleeding afterwards • avoid sexual intercourse , tampons or swimming for 1 week there is a small risk of infection , which can be further reduced by adhering to the above recommendations . You can take simple painkillers like paracetamol . If you should experience an offensive discharge , or feel unwell , then please contact your colposcopy unit or your GP for advice . On the rare occasion you may need to take antibiotics .

 

 

 

Treatment to the cervix Why do I need treatment ? You will have been advised that you need treatment following your recent smear / colposcopy identifying abnormal cells on the neck of the womb ( cervix ) . This does not mean you have cancer . However it does mean that the cells are showing some changes that may turn into cancer in the future if left untreated . This condition is known as cervical intraepithelial neoplasia ( CIN ) which is graded 1 , 2 or 3. Your own result will be discussed with you when you attend clinic . The aim of treatment is to remove the abnormal cells with minimal damage to the healthy tissue or to help prevent bleeding after sexual intercourse / problems with excessive discharge . The treatment is usually very effective , but a minority of women may require a repeat procedure .

 

 

What types of treatment are available ? Cryotherapy to the cervix Cryotherapy involves freezing the cervix ( neck of the womb ) . It is commonly used for skin conditions such as warts , but also to treat bleeding caused by a cervical ectopy . The procedure itself is simple and takes less than five minutes to perform . The area to be treated is first identified by using a speculum ( like when you have a smear test ) once visible the probe is then connected to a gas cylinder containing carbon dioxide , which is used to freeze the area . You will hear a hissing sound when the treatment starts . It is usual for treatment to be repeated more than once to completely treat the affected area . The procedure is not painful , but can be uncomfortable . Occasionally you may feel a stinging sensation . Cold coagulation / diathermy ablation This is a method of destroying abnormal cells on the cervix with the use of a heated probe , ( suitable for minor abnormalities ) . The procedure is usually performed under local anaesthetic and only lasts approximately 30 seconds , usually the discomfort is like period cramps and quickly subsides . This is a speedy non - invasive procedure , which can be carried out as an outpatient . On rare occasions deeper levels of the cervix are involved and a further treatment may be needed . The alternative would be a loop excision . 5

 

 

Loop excision sticky pad is attached to a This technique uses an electrically heated fine wire loop to remove the abnormal tissue from the neck of the womb . A lead with a machine . This forms a circuit which allows the loop to work . The tissue that is removed is sent to the have been removed . Approximately 80 % -90 % of women requiring laboratory for examination and to check that all abnormal cells treatment will be suitable for this procedure , which usually takes less than 15 minutes . If you have a large area of abnormal tissue or are very anxious , you may have the procedure under a general anaesthetic at a later date . Laser ablation This just means the laser burns away the abnormal cells . A laser beam is a very strong , hot beam of light which burns away the abnormal area . This is currently only carried out under general anaesthetic ( whilst you are asleep ) at  Hospital Knife cone biopsy This requires admission as it is performed under general anaesthetic ( whilst you are asleep ) . The abnormal tissue on the inside and outside of the neck of the womb is surgically removed . The tissue is sent to the laboratory to check that all the abnormal cells have been removed .

 

 

Frequently asked questions Which treatment will I need ? when you come to the clinic your colposcopist will discuss the treatment options and agree the best treatment for you . If you have an important event , or have arranged a holiday abroad within two weeks of your treatment , please discuss this with your practitioner as you may experience some bleeding after your treatment and might be restricted in your activities ( i.e. swimming ) for a while . What happens on the day of my treatment ? It is not advisable to perform treatments if you are having your period , if this is the case please re - arrange your appointment . Your treatment should take approximately 15 minutes however you should allow up to an hour . You may bring a friend , partner or relative who can stay with you throughout the procedure , but please be aware that if you bring children , we cannot provide childcare whilst you are having your colposcopy , so you will need to bring a responsible adult to care for your children in the waiting room . You will be asked to undress from the waist down , but you can keep your skirt on if you wish . Most treatments are carried out as an outpatient in the colposcopy clinic under local anaesthetic ( whilst you are awake ) . If you have a coil this may have to be removed prior to treatment . As most treatment is not advisable during pregnancy , please ensure that you use suitable contraception once you receive you colposcopy invitation . 7

 

 

 

The treatments are relatively painless as local anaesthetic will be Some women may experience tingling in the legs , or light used , but you may have period type pains during the procedure . headaches , this is due to the position in which you are lying . If the type of treatment you need requires local anaesthetic you might settle soon after . Following the treatment you will be asked to rest feel your legs getting a bit shaky after the injection , but that should for a short while and offered a drink . You will be given time to ask questions . Are there any risks with the procedure ? As with any procedure , there is a small chance of getting an infection . If at any time soon after , you experience heavy bleeding , which is unlikely to be a period , or the discharge becomes smelly you should seek some advice / treatment from your colposcopy clinic or GP as you may have an infection . There is a small risk that cone / loop excision might increase the risk of pre - term labour or late miscarriage especially if you fall pregnant soon after treatment , please discuss this with your colposcopist . In some rare cases the neck of the womb may become narrow due to scarring , ( this is called cervical stenosis ) . This usually happens if you had more than one treatment and it may be necessary either to widen the cervical canal in a short outpatient procedure or for future smears to be carried out in the colposcopy clinic . On return home You can expect to feel absolutely fine afterwards . However some women do feel vulnerable and weepy for a bit .

 

 

Some dos and don'ts . you must rest and avoid standing for long periods of time as this could delay recovery . you may experience period type pain . It is advisable to take simple painkillers , like those you normally take for period pain • shower if possible , or if bathing don't use any perfumed products or soak for too long , as this can delay the healing process you should refrain from sexual intercourse for 4 weeks , after which you should use contraception , and avoid becoming pregnant until you have had a negative smear result . unless told differently your next menstrual period should be due as normal , but can be slightly heavier . it is normal to have some blood loss / discharge for a few weeks after treatment . Use sanitary towels to reduce the risk of infection . Tampons should not be used for 4 weeks • if you have any heavy fresh bleeding and your period is not due , contact your colposcopy clinic or GP for advice . An out of hours ' number can be found at the end of this leaflet • avoid strenuous exercise , like aerobics / horse riding for at least a week . Avoid swimming for a least 4 weeks or until any bleeding discharge has stopped .

 

11/1 Routine smear

26/1 LLETZ 

16/3 MDT - Biopsy sent for further tests

Diary of experience: https://www.jostrust.org.uk/forum/cervical-screening-smear-test/what-were-your-waiting-times

Rb1926

Thank you so much for that ! At least I have an idea of what treatment I may have , I was hoping I wouldn't have to wait for any more results as they have already performed a biopsy but at least I won't be as worried as before . 

Thank you so much for taking the time to do that ! Xx 

23/03/20 - smear result - hpv positive . All previous smears clear. 

09/02/21 - smear result - hpv positive + high grade ( moderate ) dyskaryosis. Referred for colposcopy. 

16/02/21- colposcopy and biopsy . Awaiting results 3-4 weeks . 

04/03/21 - biopsy results in , CIN2 confirmed . Treatment booked for 23/03/21

Lemon Lavender

You are most welcome. Xx

11/1 Routine smear

26/1 LLETZ 

16/3 MDT - Biopsy sent for further tests

Diary of experience: https://www.jostrust.org.uk/forum/cervical-screening-smear-test/what-were-your-waiting-times

Hope007

Hi Rb1926 I have been wondering how you were getting on. So sorry to hear that your results came back as CIN2. At least the treatment will get rid of the abnormal cells before they turn nasty. How have you been coping are you less anxious after having the colposcopy and talking to the medical team? I am still waiting for my results and praying all will be ok!!! I really hope it all goes well for you sending big virtual hugs my lovelyxx

H

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