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COLPOSCOPY – LLETZ

colposcopy:

simple, short, painless and non-invasive examination

it enlarges the cervix through specialised equipment, the colposcope

it is a valuable diagnostic tool for the prevention and early diagnosis of cervical cancer

when to have a colposcopy:

  • PAP smear test findings show lesions indicative of HPV infection or are inconclusive
  • macroscopically obvious lesions in the cervix, vagina or vulva
  • there are symptoms such as vaginal hemorrhage after sexual intercourse or in the middle of cycle
  • presence of warts

painless examination carried out

in the doctor’s office and lasts 10 to 15 minutes

the patient should refrain, ideally for two days, from sexual intercourse, use of vaginal suppositories and vaginal washing

the patient lies down on the gynecological bed, with her legs spread and bent

the dilator is carefully placed in the vagina so that the cervix is clearly visible

then with the colposcope, the vaginal and cervical area is carefully checked

two special fluids are applied to the cervix, so that the colposcope can be used to identify the areas with lesions

if necessary, a small sample of cervical tissue is taken from the suspicious region to be sent for histological examination (biopsy)

after the colposcopy, the patient may have beige vaginal discharge for the next 24 hours

it is recommended to avoid sexual intercourse and the use of vaginal suppositories or ointments and tampons for two days

  • usual indication: in persistent LowGSIL
  • after a satisfactory colposcopy, the doctor confirms that the dysplasia is in the outer (visible) part of the cervix (in case of suspected dysplasia in deeper area, the usefulness of cauterization is reduced)
  • no part of the cervix is removed, instead the cervix is superficially cauterized
  • it is usually done with local anesthesia (often without in small lesions).
  • it usually does not require any special preparation and the patient returns to her activities the same day
  • this is a wide removal (excision) of part of the cervix
  • common indications:
  1. confirmation of diagnosis and HighSIL treatment
  2. confirmation of suspected infiltrating  cervical cancer
  3. treatment of early cervical cancer in women who have not had children

the conical resection is performed with the following techniques:

  1. with electric LOOP/LEEP/LLETZ with local anaesthesia
  2. with Laser, with local anaesthesia
  3. with a scalpel (Cold Knife)
  • in suspected primary cervical cancer, conical resection with a scalpel is surgically preferable to the LOOP wire

postoperative instructions

  • after cervical conization surgery the patient recovers immediately and can return to her activities the next day
  • it is recommended to avoid sexual intercourse, swimming in the sea, using tampons and vaginal washes for about 3-4 weeks
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