Cervical intraepithelial neoplasia: Ablative therapies
- Nicholas P Taylor, MD
Nicholas P Taylor, MD
- Section Chief of Gynecologic Oncology
- St. Lukes Hospital
- Temple University
Cervical intraepithelial neoplasia (CIN) is a premalignant cervical disease that is also called cervical dysplasia or cervical squamous intraepithelial lesions (CSIL). (See "Cervical intraepithelial neoplasia: Terminology, incidence, pathogenesis, and prevention", section on 'Terminology'.)
Treatment of CIN can either be excisional (ie, conization) or ablative. Ablative modalities are solely for treatment, while excisional therapy provides diagnostic information as well as therapeutic benefit.
Ablative therapies of the cervix will be discussed in this topic review. In addition, choosing between excision and ablation, as well as between ablative methods will be reviewed. Excisional methods for CIN treatment are discussed elsewhere. (See "Cervical intraepithelial neoplasia: Procedures for cervical conization".)
American Society for Colposcopy and Cervical Pathology guidelines include ablative therapy as an option for women with [1,2]:
●Persistent cervical intraepithelial neoplasia (CIN) 1 for two or more years (excision is preferred if colposcopy is inadequate, endocervical curettage is ungraded or positive for CIN 2,3 , or if previously treated for CIN)
- Massad LS, Einstein MH, Huh WK, et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 2013; 17:S1.
- http://www.asccp.org/ (Accessed on March 22, 2012).
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- CANDIDATES FOR ABLATIVE THERAPY
- GENERAL PROCEDURAL ISSUES
- ABLATIVE TECHNIQUES
- CO2 laser
- Cold coagulation
- ADVERSE EFFECTS AND COMPLICATIONS
- Adverse effects
- Late complications
- CHOOSING AN ABLATION TECHNIQUE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS