The treatment you need for abnormal cervical cell changes depends on whether you have mild, moderate or severe changes. Many women with mild changes don't need treatment as the cell changes go back to normal on their own.
Your doctor or nurse might use the terms cervical intraepithelial neoplasia (CIN) or cervical glandular intraepithelial neoplasia (CGIN).
After an abnormal screening test result
If your results show you have HPV then cytology will be done to look at the cells under the microscope in more detail. If the results are abnomal then you will be referred to a colposcopy clinic for a closer look at your cervix. During this examination, your doctor or specialist nurse (colposcopist) can take samples (biopsies) of any abnormal areas.
The colposcopist might offer you treatment at the same time as your colposcopy. Or you may go back for treatment once they have your biopsy results.
If you tested positive for HPV but your cytology results were normal then you will invited back for a smear test in a years time. If in a years time you still test positive for HPV, then you might be referred for a colposcopy.
Removing the area of abnormal cells
There are a few different treatments that can remove the area of abnormal cervical cells. The advantage of these treatments is that the piece of cervical tissue that the colposcopist removes can be sent for examination under a microscope.
In the laboratory, the pathologist rechecks the level of cell changes in the piece of tissue to make sure your screening result was accurate. They also closely examine the whole piece of tissue to make sure that the area containing the abnormal cells has been completely removed.
LLETZ stands for large loop excision of the transformation zone. It’s also known as loop electrosurgical excision (LEEP) or loop diathermy. This is the most common treatment for abnormal cervical cells.
Your colposcopist uses a thin wire loop to remove the transformation zone of the cervix. The wire has an electrical current running through it, which cuts the tissue and seals the wound at the same time.
The transformation zone is the area around the opening of the cervix.
LLETZ is an outpatient treatment and takes up to 15 minutes. You usually have it under local anaesthetic.
At the colposcopy clinic, your nurse asks you to undress from the waist down and then to lie on your back on the examination couch. They give you a sheet to cover yourself. Your legs are supported by 2 leg rests.
Your colposcopist gently puts a medical instrument called a speculum into your vagina to hold it open (like when you have a cervical screening test). They look through the colposcope to examine your cervix.
They inject some local anaesthetic into your cervix. This might sting for a short time. The local anaesthetic numbs the area. Your colposcopist can then remove the area of tissue with the abnormal cells. This is not painful but you may feel some pressure.
Your colposcopist then removes the speculum and you can get dressed when you’re ready.
You should bring a sanitary towel with you to the hospital. You'll need one after the treatment as there might be some bleeding.
You might have bleeding and discharge for about 4 weeks after having a LLETZ. You shouldn't use tampons or have sex during this time to reduce your risk of infection.
See your GP or contact your colposcopy nurse if you have:
- bleeding that is heavier than a period or you’re still bleeding after 4 weeks
- discharge that smells unpleasant
NETZ stands for needle excision of the transformation zone. It’s similar to LLETZ but the thin wire the colposcopist uses to cut away the area is straight rather than a loop.
You may be more likely to have this treatment if the abnormal cells are inside the passage that leads from the opening of the cervix to the womb (cervical canal).
Your doctor may suggest this minor operation to remove abnormal cells.
As with LLETZ, your doctor removes the whole area where cells can become abnormal (the transformation zone). It is called a cone biopsy because the doctor removes a cone shaped wedge of tissue from the cervix.
You usually have a cone biopsy under general anaesthetic.
In some cases, if you are past your menopause or have had all the children you want to have, your doctor may suggest removing the whole of your womb (includes the cervix).
This is more likely if you’ve had abnormal cells on your cervix more than once. Or if the abnormality found was severe. In other words, you have not got cervical cancer, but the abnormal cells on your cervix are closer to becoming cancerous cells.
Treatment to destroy abnormal cells
These treatments destroy the cells in the abnormal area. Normal cells can then grow back in their place.
These treatments include:
Despite what the name suggests, this uses a hot probe to burn away abnormal cells.
You have it in a similar way to laser treatment, but your colposcopist puts the probe onto your cervix. You shouldn't be able to feel the probe, but you might get a period type pain while you are being treated and for a short while afterwards.
This is called cryotherapy. The colposcopist uses a cold probe to freeze away the abnormal cells.
You shouldn't be able to feel the probe on your cervix, but you might get a period type pain while you are being treated and for a short while afterwards.
This treatment is less common. Laser therapy is sometimes called laser ablation. This just means the laser burns away the abnormal cells. You have this treatment as an outpatient.
A laser beam is a very strong, hot beam of light. It burns away the abnormal area. You may notice a slight burning smell during the treatment. This is nothing to worry about. It is just the laser working. You can go home as soon as this treatment is over.