Cervical dysplasia treatment in Türkiye

Cervical dysplasia (dysplasia of the cervix) is a condition in which the healthy cells in the cervix undergo some abnormal changes. The cervix is ​​the lower part of the uterus that leads into the vagina. The cervix dilates during childbirth to allow the passage of the fetus.

In cervical dysplasia, the abnormal cells are not cancerous, but they can develop into cancer if not caught early and treated.

There are many ways to treat cervical dysplasia (CIN). Factors that influence the choice of treatment for cervical dysplasia include the extent and severity of the dysplasia, the woman’s age, and whether she has any other gynecological problems. Often the expertise of the doctor or other physician, and the availability of equipment are also major factors. Here are the most common ways to treat cervical dysplasia:

Cryotherapy for cervical dysplasia

Cryotherapy, or freezing, is done by placing a probe on the cervix that cools the cervix to sub-zero temperatures. Cells damaged by freezing are discarded over the next month in a thick watery drainage. The main advantages of freezing are that it is easy to do and uses inexpensive equipment.

One problem with freezing is that the depth cannot be precisely controlled, so abnormal cells may be left behind. This is less of a problem with small areas of mild to moderate dysplasia, and more of an issue with severe dysplasia and carcinoma in situ.

Another problem with cryotherapy is that the cervix often heals with a squamo-vertical junction, within the cervical canal, making it difficult to see and causing problems with future evaluation. 

Despite these problems, most treatments agree that freezing is an acceptable treatment for small areas of mild or moderate dysplasia.  Cryotherapy has a high failure rate for treating large areas of dysplasia and dysplasia extending into the cervical canal,  so other methods are preferred when available. 

Although cryotherapy is acceptable, I stopped using it many years ago due to the excellent results obtained with lasers.

Laser treatment of cervical dysplasia

A carbon dioxide laser uses a small beam of light to vaporize abnormal cells. It can usually be done in the office without any disturbance or a bit of discomfort. The laser is directed through the colposcope so that the area and depth of treatment can be precisely controlled.

Healing after laser treatment is much faster than after cryosurgery because dead tissue is not left behind. Studies using the latest laser treatment technology show lower failure rates with lasers than with cryosurgery. Another important feature is that the cervix usually heals with a squamo-vertical junction, so that future evaluation is made easily.

The main drawback of laser epidialysis is that it requires complex equipment, and most gynecologists do not have lasers in their offices. Laser is more expensive if it has to be done in a hospital. Laser often replaces cryotherapy in hospitals where it is available.

Treatment of cervical dysplasia with cyclotomy

A loop ablation ,  also known as  LLETZ  or  LEEP  , uses   a fine wire loop with electrical energy flowing through it to remove the abnormal area of ​​the cervix. The removed tissue is sent to a laboratory for examination. Therefore, this procedure can often treat and diagnose the problem at the same time. Ring excision is usually done under local anesthesia and usually causes little discomfort. This can often be used as an alternative to a cone biopsy.

Ring excision is sometimes performed during the initial colposcopy examination. The advantage of this is that the problem is treated at the time of diagnosis, so it is not necessary to wait for lab results before treatment. Other times, a small sample may be taken at the time of the initial evaluation. This may show that no treatment is necessary or allow the choice of other treatment methods (such as laser). 

Since many women may prefer time to consider treatment options before choosing a method of treatment, I prefer to evaluate the cervix by colposcopy during the first visit, and discuss treatment options at that time, rather than treat the cervix before the woman has time to consider her options. treat it.

Cone biopsy for cervical dysplasia

A cone biopsy removes a cone-shaped or cylinder-shaped piece of the cervix. This is usually done in the operating room and can be done with a laser or with conventional surgical instruments (cold cone). A cone biopsy may be done for diagnosis or treatment, although a diagnostic cone may treat the problem at the same time.

Although laser vaporization and cryotherapy are effective treatments for dysplasia, they are not appropriate for cervical cancer. Therefore, we must be absolutely sure that there is no cancer before laser or cryotherapy

. If we cannot positively exclude cancer on the basis of colposcopy, a cone biopsy is mandatory. (This means that the turning area of ​​the cervix is ​​removed and examined rather than destroyed.)

Cone biopsy may also be chosen as a treatment for dysplasia or cervical cancer. This treatment has a high success rate, but the “cold cone” has a higher complication rate than the laser cone or ring. 

Many of the conditions that required a cold cone biopsy in the past can be treated with a laser or with the ring, with less chance of complications. 

Hysterectomy

If a woman with dysplasia or carcinoma in situ does not wish to have children in the future, a hysterectomy may be chosen. It has the lowest recurrence rate of any treatment, but it is a major surgical procedure. 

If a person has other problems that a hysterectomy might help, this operation may be the best treatment, one that will take care of all the problems at the same time. Even after a hysterectomy, dysplasia can return to the vagina, so it is essential to get regular Pap smears even if a hysterectomy is performed.

Why treat cervical dysplasia?

Dysplasia is not cancer, but it can turn into cancer if it is not treated. With the correct treatment of dysplasia and proper follow-up, we can greatly reduce the chances of developing cancer.

Once dysplasia is treated, can I forget about it?

no! No matter how dysplasia is treated, there is a chance that it will recur. Recurrences usually won’t be a serious problem if caught early, but they can eventually develop into cancer if not treated. Therefore, it is necessary to have regular check-ups after treatment.

Cervical dysplasia treatment in Türkiye

If you have cervical dysplasia, the expert team of gynecologists at REHABTÜRK can help you decide if surgery is right for you.

Therefore, you should  contact your medical advisor at REHABTÜRK to evaluate the case remotely, and then your case will be presented to specialized doctors to estimate the extent of your need for cervical dysplasia treatment in Türkiye.

Request a Free Consultation.