Treating abnormal cells after cervical screening

If cervical screening finds abnormal cells on your cervix, you may be offered treatment.

Abnormal cells such as cervical intra-epithelial neoplasia (CIN) usually affect a small area where the outer cervix meets the cervical canal. Most treatments aim to remove or destroy only this small area of abnormal cells. This means nearby healthy areas of cervix are not likely to be damaged. The removed area is checked to confirm the type of cell changes but it will also be checked for cancer cells.

Area of cervix treated

Types of treatment

There are different types of treatment. You usually only need one treatment to remove the abnormal cells completely. Your doctor will explain what type of treatment they suggest for you. This may depend on:

  • the treatments your local hospital can provide
  • the type of abnormal cells
  • the area of cervix affected.

Treatments that remove the abnormal area include:

  • large loop excision of the transformation zone (LLETZ)
  • cone biopsy.

Treatments that destroy the cells in the abnormal area include:

  • laser therapy
  • cold coagulation
  • cryotherapy.

Sometimes, a type of surgery called hysterectomy is used to remove the whole cervix and womb. This is not a common treatment for abnormal cells. Your doctor will explain if they think it is right for you.

We have more information about having a hysterectomy as a treatment for cancer.

Large loop excision of the transformation zone (LLETZ)

LLETZ is the most common treatment for removing abnormal cells from the cervix. It is sometimes called LEEP (loop electrosurgical excision procedure). It takes about 5 to 10 minutes and is usually done under local anaesthetic as an outpatient.

If a larger area of the cervix is treated, you may need a general anaesthetic and may stay in hospital for the day or overnight.

Some local anaesthetic is used to numb your cervix. Then the doctor or nurse removes the abnormal area of tissue using a thin loop-shaped tool. The loop is heated with an electric current, which cuts and seals the tissue at the same time. This should not be painful but you may feel some pressure inside your cervix.

The removed area of tissue will be sent to a laboratory to be checked and to confirm the type of abnormal cell changes.

Cone biopsy

A cone biopsy is a small operation to cut a small, cone-shaped piece of tissue from the cervix. This is usually done under general anaesthetic and you may need to stay overnight in hospital.

Afterwards, you may have a small pack of gauze (like a tampon) in the vagina to prevent bleeding. You may also have a tube to drain urine from the bladder while the gauze pack is in place. The gauze pack and tube are usually removed within 24 hours. Then you can go home.

The cone-shaped piece of tissue will be sent to a laboratory to be checked and to confirm the type of abnormal cell changes.

Laser therapy

This treatment uses a laser beam to burn away the abnormal cells. It is also called laser ablation. It is usually done under general anaesthetic and you may need to stay overnight in hospital.

Cold coagulation

Despite the name, this treatment uses heat to destroy the abnormal cells. Some local anaesthetic is used to numb your cervix. Then a small heated probe is placed onto any abnormal areas to burn them away.

Cryotherapy

A small probe is used to freeze the abnormal cells on the cervix. You may be given a local anaesthetic but often this is not needed. During the treatment you will hear a hissing noise from the gas used to cool the probe. You may have a slight stinging feeling or period-like pain while the probe is touching the cervix.

What to expect during treatment

Your doctor will explain possible side effects and what to expect during and after your treatment. Some people find this type of treatment upsetting or embarrassing. Your healthcare team will try to help. Let them know how you are feeling and tell them if you have any questions or worries.

If you want to bring someone with you for support during the treatment, this can usually be arranged.

Getting ready for any of these treatments is similar to having a colposcopy. You lie on your back on a couch or chair with leg supports. The nurse or doctor gently puts an instrument called a speculum into your vagina. They use this to open the vagina just enough to see your cervix and do the treatment through the open speculum.

After your treatment

If you have a general anaesthetic, you will stay in hospital for the day or overnight after your treatment. If you have a local anaesthetic you will be able to go home the same day.

You may feel fine after your treatment. But some people feel slightly unwell for a few hours after the local anaesthetic. It is a good idea to have the day off work, in case you need to go home and rest. You may want to arrange someone to help you home.

You may have some period-like pains for a few hours after the treatment. Some bleeding or discharge after treatment is normal. This usually stops within 4 weeks, but may last up to 6 weeks. The bleeding should not be heavier than a moderate period and should get steadily lighter.

You should contact your GP or the clinic where you had your treatment if:

  • the bleeding gets heavier - for example, completely soaking a pad within 2 hours
  • the discharge smells unpleasant
  • you have a fever or temperature
  • you have severe pain
  • you are worried for another reason.

It will take a few weeks for the cervix to heal. Your doctor or nurse will probably advise you not to have sex for at least 4 weeks after your treatment. This allows the cervix to heal properly. You may also be advised not to use tampons or swim for 4 weeks, and to wash or shower rather than have a bath.

Your treatment should not affect your ability to enjoy sex once your cervix has healed.

Fertility and pregnancy after treatment

Your treatment should not affect your ability to get pregnant. But very rarely, the cervix can become tightly closed after treatment. This is known as stenosis. It may make it harder for sperm to enter the womb and so can affect your chances of becoming pregnant naturally. Your cervix is not completely closed if you still bleed during your periods.

Removing some of the cervix may make it slightly weaker. This depends on how much needs to be removed. If you get pregnant, you may be more likely to give birth early if your cervix is weakened. Some women may be referred to a local specialist maternity service for closer monitoring during pregnancy. Your doctor can tell you more about this.

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