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Cervical conization refers to an excision of a cone-shaped portion of tissue from the mucous membrane of the cervix. Conization is used for diagnostic purposes as part of a biopsy and for therapeutic purposes to remove pre-cancerous cells ( cervical intraepithelial neoplasia ) or early stage cervical cancer .
Endocervical curettage is a medical procedure used to extract cells of the endocervix to visualize under a microscope. Direct cervical visualization, colposcopy, and even endocervical colposcopy are not enough to fully analyze all areas of the endocervical epithelium and thus endocervical curettage is the method of choice in cases where this is necessary.
Complications are less frequent in comparison to a cold-knife conization but can include infection and hemorrhage. [10]LEEP effectively reduces the risk of cancer developing or spreading but it causes an increased risk of premature birth in future pregnancies.
Locations of colposcopy findings can be described in terms of quadrants, or corresponding to a clock face when the subject is in supine position. One model for scoring colposcopy findings is the Swede Score, which assigns a score between 0 and 2 for five different parameters, based on what is visible during the colposcopy, as given in table below:
A biopsy, or sample of the tissue, is the first step in determining the type and extent of cancer. This biopsy may be obtained through a punch biopsy, LEEP (loop electrosurgical excision procedure), or cone biopsy. These procedures allow the doctor to obtain a sample of the cancerous tissue to look at under a microscope.
Surgical procedures performed on the cervix such as colposcopy, cone biopsy, or a cryosurgery procedure [3] Trauma to the cervix [3] Repeated vaginal infections [3] Atrophy of the cervix after menopause [3] Cervical cancer [1] Radiation [1] Cervical nabothian cysts
Some of the follow-up options include surveillance, histological diagnosis via colposcopy/biopsy, or removal of the abnormal tissue via an ablative or surgical method. [ 2 ] The World Health Organization outlines two different approaches to cervical screening and follow-up.
Because of this, LSIL results can be managed with a simple "watch and wait" philosophy. However, because there is a 12–16% chance of progression to more severe dysplasia, the physician may want to follow the results more aggressively by performing a colposcopy with biopsy. [7] If the dysplasia progresses, treatment may be necessary.