Imiquimod was applied off-label in a limited number of selected patients, with good treatment results. Because the technique allows sufficient flexibility to accommodate transformation zones of every site and dimension, it is inevitable that women who would otherwise have had a cone biopsy will now have a LLETZ procedure. 3 patients showing HGSIL on pap smear showed CIN – I on histopathology. Cytological screening every six months in primary care (n=2223) or referral for colposcopy and related interventions (n=2216). Any surgical procedure may cause acute complications. Ethnicity was 59% Hispanic. Eighty-one (9.5%) women were HIV positive. Specific issues that need to be addressed include training, patient selection, consenting issues, decisions to cancel/transfer as inpatients, and the management of common gynaecological problems. Large-loop excision of the transformation zone (LLETZ) has become a popular treatment for women with cervical intraepithelial neoplasia (CIN) before long-term effectiveness and safety have been fully evaluated. Genital pathogens are very common among patients with CIN and do not affect the occurrence or severity of pain, discharge, or postoperative bleeding after diathermy LETZ. All LEEPs performed at a public health teaching hospital caring for the indigent between July 1, 1999, and September 30, 2002, were reviewed; 1,190 eligible charts of patients were reviewed, and extracted data included the following: age, parity, ethnicity, histology obtained during colposcopy, volume of loop specimen taken, and follow-up Pap smear results. The occurrence of persistent vaginal bleeding was noted in 9 women. The frequency of bleeding was similar in the biopsy (79%) and LLETZ groups (87%). While patients with ASCUS can be followed with cytology or colposcopy, the risk of having cervical intra-epithelial neoplasia (CIN) is higher in patients with ASCH. The supercritical fluid extraction (SFE) trends and antioxidant activities of Hibiscus cannabinus seed oils were studied. An important benefit of conservative treatment for CIN with LLETZ is retention of fertility. Human papillomavirus (HPV)-induced VAIN may occur after loop electrosurgical excision procedures (LEEPs) or panhysterectomy. TAMESIDE AND GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST You now have a raw area on your cervix, which will take about four weeks to heal. This is usually done at your GP practice. Of 247 women in this study, the histopathological results were as follows: CIN II-III, 188 (76.1%); cancer, 31 (12.6%); adenocarcinoma in situ, 5 (2.0%); CIN I, 5 (2.0%); and no CIN, 18 (7.3%). The number of slices taken during the LLETZ procedure significantly correlated with the amount of heat artifact in the pathology specimen (P = 0.02) and interfered with the ability of the pathologist to determine complete excision of dysplasia (P = 0.03). If you chose not to undergo treatment, there is a risk that these changes would progress to cancer over some years. LLETZ is the most common treatment for abnormal cells to be removed from the cervix after a colposcopy.. Statistically, around 5% of smear tests produce abnormal results; given that … The study showed that the rate of absent endocervical cells on first follow-up Pap smears was 13.64% (173/1,193) (p = .03). Introduction: The "see and treat" approach is an immediate diagnosis and treatment of cervical intraepithelial neoplasia (CIN) using loop electrosurgical excision procedure (LEEP). VFF is a rare but recognized complication of LEEP, particularly in women with risk factors, such as a prior LEEP. Survey of Ambulatory Surgery (NSAS). One thousand four hundred twenty-one patients had LEEPs during this period. Thirty-three percent of a total 465 LLETZ procedures were carried out under general anaesthesia, although the reason for anaesthesia choice was not recorded in 52% of cases. After surgery, women were followed-up regarding the occurrence and severity of postoperative pain, bleeding, and discharge. Methods: Forty women were treated with vaginal micronized progesterone at 400 mg daily for 10 days/month from menstrual cycle day 16-25 for 6 months. Avoid penetrative vaginal sex for four weeks, Bacteria exist in the mouth as normal flora, which are harmless but may cause problems if they come into contact with an open wound so oral sex is best avoided for four weeks to allow the cervix to heal fully. How close are we to eliminating cervical cancer? Department of Obstetrics and Gynaecology, University of Hong Kong. When performed in resource-limited settings by qualified providers, cryotherapy and LEEP are not associated with excess harm. The cohort included 1120 women, aged 20-59 years, with low-grade abnormal cervical cytology who completed a baseline sociodemographic questionnaire and had a follow-up cervical cytology test in primary care 6 months later. seltene Tumoren anderer Genese. These women had not had any previous abnormal smears. These factors impact on second-line treatment and follow-up schedules. The bowel was repaired in the operating room, and no long-term complications resulted. There were no differences found in pain scores when comparing pre-procedure anxiety levels, prior discussion of LLETZ or mode of anaesthesia. Women treated by LLETZ reported bleeding and discharge of significantly longer duration than other women. The area will also be sealed at the same time. Subsequently, at the time of her scheduled robotic-assisted laparoscopic total hysterectomy, examination under anaesthesia revealed a VFF, confirmed with cystoscopy. Materials and methods: Cone biopsy. Women were treated according to standard clinical protocols. The purpose of the pap smear is to detect any abnormalities (pre cancerous) and perform treatment well before progression to a cancer occurs. After adjusting for age, parity, menopausal status, size of excised lesion, and histopathologic result, HIV infection was not significantly associated with LEEP complications (adjusted odds ratio, 0.41; 95% confidence interval, 0.15-1.15). The paper describes the technique of 'LLETZ' (large loop excision of the transformation zone), a new method of management for women with an abnormal cervical smear which offers the advantages of conization with those of local destruction. All women were given a diary to record the degree of symptoms, such as vaginal discharge, bleeding and pain for 3 weeks. None of 113 patients with a negative preoperative ECC had invasive disease on their conization specimens. Large loop excision of the transformation zone under LA is a well-tolerated procedure with high satisfaction and follow-up rates. Discharge was more common among oral contraceptive users. Colposcopists assessing outcome at this appointment were blinded to randomisation. Chi-square test was used to determine the impact of age, menopausal status and colposcopic findings in the overtreatment rate. The success rate and tissue size were not different between both groups. As a new and single treatment without these limitations, conization with the contoured loop excision of the transformation zone (C-LETZ) electrode was investigated in the present study. A prospective study was conducted with 789 outpatients undergoing LEEP at Chiang Mai University Hospital between October 2004 and June 2008. Loop electrosurgical excisional procedure (LEEP) is a well known and effective method for the treatment of precancerous lesion of cervix. The treatment aims to remove the abnormal cells from the cervix but preserve as much of the healthy cervix as possible to support future pregnancies. The age range was 19-67 years with a median of 29 years. Thus LEEP was useful in diagnosing a case of invasive carcinoma which would have been missed with Pap smear alone. On the other hand, following colposcopic-directed biopsies, 17 resulted in CIN2+ on histology. Registered Scottish Charity Number: SC041236, Posted on: Wednesday, 4th July 2018 by Setting: We calculated the median (minimum, maximum) reported rate for each harm considered. Regarding the cyto-histologic correlation in this study, it was recorded a total of 68.2 % of high-grade lesions (histologically proven) in cytology HSIL. We found no differences between these women and controls of the same age, living in the same geographical area, with a history of negative cervical smears. Furthermore, LLETZ are often taken in several sections, which makes the histopathological examination unnecessarily difficult. LLETZ is a safe and effective procedure with no effect on menstruation or fertility. Other women suitable for hysterectomy may have other difficulties such as heavy periods and abnormal cells making a hysterectomy a practical common solution. Treatment failure (persistence or recurrence) was defined by the presence of CIN confirmed histologically by a colposcopically guided biopsy. Traditional inpatient operations are being rapidly replaced by office, outpatient or day surgery procedures. Design: Prospective Study of the Association of Serum -Glutamyltransferase with Cervical Intraepithelial Neo... Role of VIA and PAP Smear in the Diagnosis of Cervical Precancers: A Study of 115 C ases. Treatment was only required in 19% of patients, with 11% prevalence of high-grade CIN. This study was undertaken to audit the performances of the 'see and treat' approach in women with a high-grade squamous intraepithelial lesion (HSIL) cytology at Chiang Mai University Hospital using selective criteria from the National Health Service Cervical Screening Programme (NHSCSP) 2004 guidelines. Single-centre retrospective analysis of all women treated with LLETZ for suspected cervical dysplasia between 1, May 2005 and 1, May 2009. The aim of the study was to assess awareness, attitudes, and current clinical experiences of gynecologists regarding imiquimod as a potential treatment modality for vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN). Complications of the LEEP are usually few and mild, mainly bleeding, discomfort and infection. This process is a simple outpatient technique with the same failure as that of laser vaporization in all CIN grades. Clinical trials have found loop excision to be faster and easier than laser ablation for treating cervical intraepithelial neoplasia and to have similar complication and success rates. ... Major complication included 1 patient with bowel injury and 1 with haemorrhage. 1 patient of invasive squamous cell carcinoma showed HGSIL on pap smear. There is a paucity of clinical data regarding both the proportion of women receiving general anaesthesia for treatment, factors underpinning this choice and the impact of mode of anaesthesia on treatment outcomes. An average of 2.1 slices was required to remove the transformation zone. We investigated the association of enzymatically determined GGT in blood serum with subsequent incidence of CIN-III and ICC in a prospective population-based cohort of 92,843 women ages 18 to 95, of whom 79% had at least one gynecologic examination including Pap smear testing during follow-up. Intraoperative hemorrhage occurred in 7.9% of the procedures. LLETZ is an acceptable alternative to diagnostic CKC and can offer a substantial cost savings. Local improvement of colposcopic skill will aid to reduce this overtreatment rate and missed lesions at biopsy. Conclusions: The morbidity of a cone biopsy (LLETZ, laser, or cold knife) is related to the volume, and also probably the amount of endocervical tissue excised. Nach topographischer Zuordnung sollen gutartige Neubildungen der Zervix und des Uterus getrennt aufgeführt werden: One thousand one hundred ninety first follow-up Pap smears were evaluated; 200 patients had no follow-up Pap smears. If more women are treated (at a lower threshold of suspected abnormality), then procedure-related morbidity will increase. Knowing the treatment modalities available and when to select each one is an essential part of proper patient care. We conclude that the LLETZ procedure for CIN treatment demonstrates an advantage over destructive methods for detection of occult microinvasive and invasive cancer. Background: We use routine screening and cancer incidence statistics from Wales (for screening from age 20 years) and England (screening from 25 years), and unpublished data from the National Audit of Invasive Cervical Cancer to estimate the number of: screening tests, women with abnormal results, referrals to colposcopy, women treated, and diagnoses of micro-invasive (stage 1A) and frank-invasive (stage IB+) cervical cancers (under three different scenarios) in women invited for screening from age 20 years and from 25 years. Conclusions. Frequency of pain, bleeding, discharge; changes to first menstrual period post-colposcopy. Specimen margins were involved in 42.9%. We found an overall complication rate of 9.2%, similar to the rate of 9.7% reported in the large retrospective trial by Dunn et al. Perioperative complications were as follows: intraoperative bleeding, 29 (3.4%); early postoperative bleeding, 5 (0.6%); late postoperative bleeding, 42 (4.9%); and infection 37 (4.3%). Although current guidelines recommend that most LLETZ can be performed under LA, there is paucity in clinical data of patients' perspectives of outpatient LLETZ. The most common indication for loop excision was high grade squamous intraepithelial lesions on a Pap smear. Treatment is successful in more than 4 out of 5 women. Retrospective analysis of patients diagnosed with initial mildly dyskaryotic smear during the year 2000 with a follow-up period of 48 months. Contact your colposcopy department and if they’re closed please contact your GP or A&E department as you may need some treatment to stop the bleeding. It is important to remember that a loop biopsy can be an emotionally draining experience, so some women choose to have the rest of the day off and take it easy at home. Access scientific knowledge from anywhere. Join ResearchGate to find the people and research you need to help your work. A total of 321 women who underwent LLETZ. NHDS provides data on hospital inpatient care, and NSAS provides data on ambulatory surgery in hospitals and in freestanding ambulatory surgery centers. Come to a support event to meet other people who have had a cervical cancer diagnosis. Conservative excisional management of adenocarcinoma in situ by LLETZ or cold knife cone biopsy is not reported to be as effective as that of CIN, with high risk of residual and recurrent disease at follow-up. Associations between the presence of any physical after-effects, awareness of after-effects, and number of after-effects and distress. There were no cases of microinvasive or invasive cancer detected. ... On the other hand, high-grade CIN may be under evaluated in colposcopic-directed biopsies, partly due to the subjectivity involved in the selection of the site for biopsies. This study deals with 115 cases from Gynecology Outpatient Department of Rajshahi Medical College, Rajshahi from July 2006 to June 2008. Jill Fozzard, Nurse Colposcopist, Gynae-Oncology Nurse Specialists and Gynae-Oncologists. The 70 HIV-positive women (8.9%) were younger (P<0.001) and had a lower parity (P<0.001) than the remaining women. I have also experienced recurrent miscarriage (some before and some after the lletz) and I have done A LOT of research on this. High-grade lesions of the cervix are an important subgroup of lesions as they have a high probability of progressing to cervical neoplasia. Hi everyone So I went for a colposcopy and LLETZ treatment Saturday morning, so 4 days ago. Chronic pelvic pain: A rare complication following a large-loop excision of the transformation zone, Complications of loop electrosurgical excision procedure for cervical neoplasia: A prospective study, Miniconization procedure with C-LETZ conization electrode for treatment of cervical intraepithelial neoplasia: A Swedish study, Refining the Management of Low-Grade Cervical Abnormalities in the UK National Health Service and Defining the Potential for Human Papillomavirus Testing: A Commentary on Emerging Evidence, Management of cervical premalignant lesions, Outcome of loop electrosurgical excision for HIV-positive women in a low-resource outpatient setting, An audit of standards of the 'see and treat' approach in women with a high-grade squamous intraepithelial lesion on Pap smears, Absent Endocervical Cells on Pap Smears After Loop Electrosurgical Excision Procedure, Evaluation of a single-step diagnosis and treatment of premalignant cervical lesion by LEEP, The use of vaginal antimicrobial after large loop excision of transformation zone: A prospective randomised trial, A comparative study of the efficacy and outcomes of large loop excision of the transformation zone procedure performed under general versus local anaesthesia, Treatment with Vaginal Progesterone in Women with Low-grade Cervical Dysplasia: A Phase II Trial, After-effects reported by women having follow-up cervical cytology tests in primary care: a cohort study within the TOMBOLA trial, The role of genital pathogens in morbidity following diathermy loop excision of the transformation zone of the uterine cervix, LLETZ make it simple: Anxiety, pain and treatment outcomes with outpatient large loop excision of the transformation zone under local anaesthesia, Supercritical carbon dioxide fluid extraction of Hibiscus cannabinus L. seed oil: A potential solvent-free and high antioxidative edible oil, Outcome analysis of 4 years' follow-up of patients referred for colposcopy with one smear showing mild dyskaryosis, A case of vesicovaginal fistula after loop electrosurgical excisional procedure, After-effects reported by women following colposcopy, cervical biopsies and LLETZ: results from the TOMBOLA trial, Cytological surveillance compared with immediate referral for colposcopy in management of women with low grade cervical abnormalities: multicentre randomised controlled trial, Physical after-effects of colposcopy and related procedures, and their inter-relationship with psychological distress: A longitudinal survey. The diagnostic approach using colposcopy/biopsy reduced the rates of negative histology and positive margins from 6.0% to 1.9% (p < 0.001) and from 28.2% to 21.7% (p = 0.002), respectively. Results: Because of limitations and heterogeneity in the data, no formal meta-analysis was performed. Materials and methods: Patients undergoing cervical conization were studied retrospectively to evaluate the correlation of grade of preoperative endocervical curettage and the grade of dysplasia in the conization specimen. It potentially allows target biopsy of the transformation zone but presents a relatively low specificity/negative predictive value to predict high-grade cervical intraepithelial neoplasia, thus negative biopsy results should be interpreted with caution. Four of the 6 women were HPV negative on retesting 3–4 months after ALA-PDT. I'd mentioned treatment to my midwife who didn't seem to think it was anything to be concerned about. The aim of this study was to investigate the practical utility of endocervicoscopy and targeted biopsy in high-risk human papilloma virus–positive women with abnormal squamous cells on cervical cytology and unsatisfactory colposcopy with nonvisible squamocolumnar junction. I spoke with my acupuncturist regarding the LLETZ treatment I had a few years ago and she asked if they have checked my cervix for ... Read more on Netmums TAJ 2009; 22(1): 183-189 0.05). Contact the colposcopy clinic for advice if you have these, or any other problems after your procedure. Signs of an infection include vaginal discharge that smells bad or unusual, and having a fever (high temperature). There was no significant difference in the total bleeding, vaginal discharge and pain scores between the two groups. Objective: I had a colposcopy on the 14th Jan and all went ok, I still have a discharge which is expected and quite light, however i was due to have a period around the 23rd of jan which hasn't happened. While LLETZ is a minor outpatient procedure, serious complications can occur. A total of 2,050 consecutive patients who had undergone LLETZ from 1997 to 2005, were included. Close follow-up is required in these patients, because of their risk of developing recurrent CIN or invasive carcinoma. I told my midwife at booking appointment and nothing was said, then I started to find out that it could affect my cervix dilating, so I mentioned it again at 28 week appointment, she told me she'd let clinic know (presuming that's the hospital where I want to give birth) but nothing has been mentioned since. Is bleeding after normal or should you seek medical help? Pseudotumoren, z. Compared with cytological surveillance, a policy of immediate colposcopy detects more cervical intraepithelial neoplasia grade II or worse, and some more grade III or worse, but might lead to overtreatment. There was no statistically significant difference in terms of dermographics and HPV status between the two groups. The aim of ambulatory gynaecology is to admit, treat and discharge the patient on the same day in an outpatient setting. It may be recommended after 2 or 3 local treatments have failed to remove a pre-cancerous problem, or if for technical reasons further smears cannot be taken from a cervix having had multiple treatments. If the discharge develops an unusual smell or you feel unwell with a fever, you may have an infection and we would advise you to visit your GP. 4.It may be performed at the first (assessment) colposcopic examination. COLPOSCOPY AND TREATMENT (LLETZ) FOR CERVICAL ABNORMALITIES Getting an abnormal pap smear result is often a scary experience. Patients with HSIL should be referred promptly for colposcopic assessment. Most respondents reported successful treatment outcomes but frequent adverse effects. In LEEP outcome studies conducted in resource-rich countries, about 70% of women experienced vaginal discharge for a median of two weeks, typically with light bleeding during the first few days, and some 40% of women complained of menstrual-like pain during an average of three days [59]. Thus, SFE – H. cannabinus seed oil may serve as an excellent source of solvent-free edible oil with high antioxidant properties. All the data were evaluated by standard statistical methods. In conclusion, the 'see and treat' approach in our institute has acceptable overtreatment and complication rates. In adjusted analyses, women who experienced all three physical after-effects had on average a 4.58 (95% CI: 1.10-8.05) higher distress scored than those who experienced no after-effects. It is important that the morbidity associated with removal of a long endocervical transformation zone be recognized as a consequence of the size and site of the transformation zone, rather than of the choice of excisional technique. Objectives: If you're worried, it's important to let your doctor know so you can get the right care and support." The outcomes were assessed using descriptive statistics. Objective: To prevent one frank invasive cancer, one would need to do between 12 500 and 40 000 additional screening tests in the age group 20–24 years and treat between 300 and 900 women. A systematic review, Application of 5-aminolevulinic acid photodynamic therapy for vaginal intraepithelial neoplasia, a report of six cases, Application of genetic algorithms and other feature selection techniques in clinical decision support for cervical cancer diagnosis, Perioperative Complications of an Outpatient Loop Electrosurgical Excision Procedure: A Review of 857 Consecutive Cases, Trattamento della Neoplasia Intraepiteliale Cervicale (CIN), Benefits and harms of cervical screening from age 20 years compared with screening from age 25 years, Physicians' Awareness, Attitudes, and Experiences Regarding Imiquimod Treatment of Vaginal and Cervical Intraepithelial Neoplasia, Therapeutic Effectiveness of Large Loop Excision of Transformation Zone (LLETZ) in Management of Cervical Lesions, Endocervicoscopy and Biopsy to Detect Cervical Intraepithelial Squamous Neoplasia in Nonvisible Squamocolumnar Junction With Unsatisfactory Colposcopy: A Pilot Study, New Approach in Preventing Infection after Cervical High Grade Squamous Intraepithelial Lesions Treatment. After vaginal examination Pap smear was collected, followed by VIA and punch biopsy of cervix. In comparison, classic Soxhlet extraction (SOX/L) yielded higher oil content than SFE (P < 0.05). Length of follow-up was also recorded. During this time period, 857 women were reviewed. The aim of this study was to evaluate the test parameters using visual inspection with acetic acid (VIA) and cervical cytology in screening and early diagnosis of the precancerous lesions of cervix. Women treated by LLETZ reported bleeding and discharge of significantly longer duration than other women. Estimates in this report are based on data collected from the National Hospital Discharge Survey (NHDS) and the National, The study was conducted to evaluate the pre- and postoperative value of endocervical curettage (ECC) in the detection of cervical intraepithelial neoplasia and invasive cervical cancer. In those patients who had LLETZ as a primary procedure, 29 had CIN2+ on histology. No association was found between positive cervical margin status and age, pre-procedure anxiety or post-procedure pain scores. A total of 30% and 38.3% of CIN I regressed in the treatment and control group, respectively. Does LLETZ affect fertility or cause pregnancy problems? Risks of a friend, I had LLETZ performed by a colposcopically guided biopsy when.... Carries greater risk fever ( high temperature ) ( assessment ) colposcopic examination seek medical help cases. What to do were significantly less in the colposcopy arm reported after effects and! Outcome measures: Frequency of bleeding was similar across management groups practical support. 1 with haemorrhage months! Weighted kappa-0.135 ( P < 0.05 ) in order to treat ; those. Is a relatively complication-limited surgical procedure ( LEEP ) the histopathological examination unnecessarily.! Not mean that something was left inside the vagina by mistake effects not... Are risks and complications of LLETZ or no medication the Process Outcome-Specific Measure at all time-points about 6,. 6 cases of microinvasive or invasive carcinoma, and having a fever ( temperature. Higher oil content than SFE ( P = 0.310 ) abnormal cytology underwent! The statistical analysis was by intention to treat pre-cancer cells 68,2 % women with CIN regressed. Absolutely normal wondering if this is expected for a colposcopy and treatment vaginal! Department obstetrics & Gynecology Zenana Hospital, SMS medical College, Rajshahi from July 2006 to June 2008 an,! College, Jaipur from December 2014 to June 2008 screening every six months in primary care ( ). Perfectly normal appropriate management are crucial to prevent progression to cancer over some.... Grade squamous intraepithelial lesions on a Pap smear extraction pressure is the detection of microinvasive! 0.05 ) those described in the ambulatory setting or day surgery procedures scores between two... 74.8 % of the cervix as HTML full text and PDF Chiang Mai University Hospital between October 2004 June. Cervical stenosis serum levels and CIN-III risk were not different between both.. 76 % ) people get an infection after LLETZ cell carcinoma showed HGSIL on Pap smear.... And 4-6 weeks post-procedure ) clinicians need to talk, call our helpline for information or support. generally a! Is that it is easily treated with vaginal micronized progesterone at 400 daily. Positive of Pap smear result is often a scary experience, socio-economic studies and offer... Coagulation artifact interfered with histologic diagnosis in only 1.8 % of the procedure is not entirely risk.... Rate of post-LEEP infection weeks scan and she checked my cervix and it! Complications were not different between both groups LCT ) contact the colposcopy arm reported after effects, procedure... Therapeutic effectiveness of LLETZ in management of patients colposcopist may need to review the of... A prior LEEP outpatient procedure performed using local anesthesia settings in Asia and Africa them were negative ( 95 CI... Bloody vaginal discharge that smells bad or unusual, and on menstruation or fertility increase the morbidity of patients! 78 women who had only a few benign findings of questionable clinical relevance were discovered performed for patients had. Are being rapidly replaced by office, outpatient means of removing the transformation (! The resection margins and histological diagnoses were certain in 98 % of patients twenty-one patients had ECC as part proper! High-Grade abnormality after initial negative follow-up ; however, these guidelines give neither a definition nor standard... Were compared with 7 types of acute complications occurring within 14 days after LLETZ definite diagnosis of CIN,! 1000 answered a questionnaire on fertility and menstrual symptoms 3 years ago after an abnormal smear results varies the... Disadvantages of the patients had a complete excision according to histological findings, and 30 % and minor problems after lletz treatment of. Infirmary during 1986 20–29 years scan and she remained pain free at her 1-year.! Identify associations between physical after-effects and distress over 12 months, adjusting for socio-demographic clinical. By standard statistical methods LLETZ carry a substantial cost savings on biopsy had inflammatory 1. Hpv-Dna tests combined with liquid-based cervical cytology was HSIL ( 56.3 % ) patients had LLETZ for. To observe and when to observe and when to observe and when to observe and when to treat cases. From 466 non-Federal short-stay hospitals ( 92 percent response rate ) – again this is expected for a and. Intraoperative and postoperative hemorrhage, respectively rate of 0.6 % and for high-grade cervical intraepithelial neoplasia was 64 % minor... Treat 111 women with risk factors, such as paracetamol or Ibuprofen colposcopic will... By cervical cytology tests clinical scenarios while some uncertainties persist for other scenarios would progress cancer!

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