What Is The Best Treatment For Dysplasia?

My 22-year-old daughter has had two abnormal Pap smears. They have now said she has precancerous cells that require surgery. I would like to know which of the methods you would suggest. She is debating between laser or the freezing method. Any help you can give will be appreciated.

Cryotherapy (freezing), laser vaporization, and loop electrode excision procedure (LEEP) all treat precancerous cells. But in certain situations, one method is preferable to another. The findings at colposcopy usually help determine the procedure of choice.

To begin with, is a specimen needed for the pathologist to examine? This is important when dealing with an advanced lesion, or one that has failed previous attempts at treatment. Cryotherapy and laser vaporization both destroy the superficial layers of cells on the cervix, so there is no specimen to examine. When a LEEP is performed, a scoop of tissue is removed which is then evaluated by the pathologist.

How large is the lesion (area of abnormal cells)? For cryotherapy to be effective, the lesion needs to be completely covered by the metal probe, so size is an issue. Location is also important, because freezing is not as successful if the lesion extends high into the cervical canal. Laser vaporization is used in cases when the lesion is too large, extends into the canal or involves the deep glands of the cervix.

Recovery time also varies with the different techniques. With cryotherapy, there is mild cramping during the procedure and vaginal discharge for up to four weeks afterward. Laser vaporization causes cramping, and a local anesthetic is generally used. Vaginal discharge is briefer following a laser treatment, lasting only five to ten days on average. LEEP is comparable to the laser vaporization, both in terms of discomfort during the procedure and the discharge following.

As the cervix heals, the abnormal cells are replaced by healthy new cells. During this process, the location of the transformation zone (squamocolumnar junction) can change. The transformation zone is the area on the cervix where the inside cells (columnar epithelium) meet the outside cells (squamous epithelium), and since this is where abnormal cells usually develop we like to keep an eye on it. Normally, it’s located on the outside of the cervix, where it’s easy to see during colposcopy. With laser vaporization, the junction usually returns to the outside, making follow-up examination easier. Cryotherapy, however, can move the junction into the cervical canal, which can make it harder to assess.

I hope this information will help your daughter talk to her doctor to find what procedure is best for her.

The information provided on Health Search Online is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment.