Treating abnormal cells in the cervix

You may require treatment if the results of your colposcopy indicate abnormal cells in your cervix.

Treatment typically aims to remove the area of abnormal cells. This usually involves removing an area of the cervix about the size of a finger-tip.

The specific type of treatment recommended will depend on the number of abnormal cells in your cervix and how advanced the abnormalities are.

The aim of treatment is to remove the abnormal cells while minimising damage to healthy tissue. Treatment is nearly always 100% successful, and it is unlikely cell changes will occur again.

Timing of treatment

It is often possible to have treatment at the same time as your colposcopy. This may be more convenient for you than having to make another appointment for treatment at a later date.

Some women find waiting for treatment causes anxiety, and prefer to be treated as soon as possible. Others prefer time to think about their treatment and schedule it for another time.

Some more intensive treatments cannot be done on the same day as a colposcopy. Your colposcopist will advise about the best time for your treatment to be carried out. They will also be able to discuss treatment options with you, and what each type of treatment involves.

Some available treatments are discussed below

       1.      Large loop excision of the transformation zone (LLETZ)

The large loop excision of the transformation zone (LLETZ) is the most common treatment for abnormal cervical cells. LLETZ is also known as loop diathermy, loop cone, loop biopsy or loop excision.

LLETZ can sometimes be carried out at the same time as a colposcopy and involves cutting out the area of the cervix where abnormal cells have developed. This is done using a thin wire loop that is heated with an electric current. A small ball electrode is used to seal the wound.

LLETZ usually takes 5-10 minutes. It is usually carried out under local anaesthetic (medication that numbs the area), which is injected into your cervix with a needle. The procedure is not usually painful, although you may feel some pain similar to period pain.

If a larger area of the cervix needs to be treated, the procedure will take longer and you may need a general anaesthetic (where you are put to sleep).

You will need to bring a sanitary towel with you as you will bleed after having LLETZ. You may also have some light bleeding for several weeks after the procedure.

After having LLETZ you should avoid:

- using tampons for four weeks (use sanitary pads instead)

- having sexual intercourse for four weeks

- heavy exercise for two to three weeks

These all increase your risk of developing an infection after the procedure has been carried out.

There is some evidence to suggest women who are treated with the LLETZ procedure have an increased risk of premature birth in future pregnancies. However, in the most cases benefits of treatment will greatly outweigh this small risk. Your doctor can advise further about this if necessary.

      2.     Cone biopsy

It is not possible to carry out a cone biopsy at the same time as a colposcopy. A cone biopsy is a minor operation that may require an overnight stay in hospital. It is carried out less commonly than LLETZ and is only really used if a large area of tissue needs to be removed.

A cone biopsy is carried out under general anaesthetic. A cone-shaped piece of tissue is cut away from your cervix with a scalpel. The section of tissue removed may include the whole area of cervix where the abnormal cells are located. The tissue will be sent to a laboratory for closer examination under a microscope.

Following a cone biopsy, a piece of gauze (a dressing made of absorbent material) may be placed in your vagina to help stop any bleeding. If you require a gauze pack, you may also need a catheter inserted (a thin tube that drains urine from your bladder) as the pack can sometimes press on your bladder. You may need to stay in hospital overnight – please ask your doctor or nurse for more advice.

It is normal to bleed for up to four weeks after having a cone biopsy. You may also have some period-like pain, although any discomfort should only last for a couple of hours. Painkillers can be used to help ease the pain.

Take plenty of rest during the first week after having a cone biopsy. You will not need to stay in bed but you should avoid tasks such as heavy lifting. Also avoid vigorous exercise and having sex during the first four to six weeks after the biopsy. After this time, the tissue in your cervix should have healed.

While recovering from your operation you may also find it useful to arrange for a relative or friend to stay with you for a few days to help with difficult tasks.

Other treatments

Abnormal cells can be treated in several other ways, without removing them. Your doctor can give you more information and advice about the procedures briefly outlined below and whether they are appropriate to your circumstances.

      1.      Cryotherapy

Cryotherapy is a form of treatment that involves freezing and destroying any abnormal cells. During the procedure, you will lie on a couch and a doctor will insert an instrument called a speculum into your vagina. They will then freeze and destroy any abnormal cells.

During cryotherapy, liquid carbon dioxide is passed through a probe and directed at the abnormal cells. The tissue will be frozen for two to three minutes, and the process may be repeated if necessary.

You may feel period-like pain during cryotherapy, and for a short time after the treatment has finished.

      2.     Laser treatment

      Laser treatment involves the doctor using a laser to pinpoint and destroy any abnormal cells on your cervix. A local anesthetic will be used to numb the area being treated.

The abnormal area will be burned away using a hot beam of light produced by the laser. There may be a burning smell during this procedure, but this is normal and nothing to be worried about. 

You can return home as soon as the laser treatment is finished.

      3.     Cold coagulation

Cold coagulation involves applying a heat source to the cervix that burns away and removes the abnormal cells. You may feel period-like pain during cold coagulation treatment, and for a short time afterwards.

      4.     Hysterectomy

A hysterectomy (surgical removal of your womb) will only be considered if abnormal cells on your cervix have been found more than once or if they are severely abnormal.

Removing your womb will usually only be an option if you have decided not to have any more children or you have had the menopause.

After treatment

Following treatment on your cervix, you are likely to be advised to avoid:

-  using tampons for four weeks after your treatment

-  having sexual intercourse for four weeks after your treatment

-  going swimming for two weeks after your treatment