TREATMENT following a COLPOSCOPICALLY DIAGNOSED IRREGULARITy

The Procedure

The doctor will advise you about which area requires an operation, for example, vagina, vulva, cervix, perianal or perineum area. He/she will also inform you which of the procedures listed below will be carried out:

·       Pelvic region wart removal. During this operation, the doctor can burn (with a laser) or cut off warts.

·       Cone biopsy of the cervix. In this operation, the affected pelvic area is scooped from the cervix through diathermy, either with a scalpel or by LLETZ (loop electrosurgical excision procedure).

·       Electrosurgical Diathermy or Laser Treatment is used to destroy the abnormal tissue areas.

Risks of the Procedure

After electrosurgical diathermy or laser treatment, there may be possible risks or problems, such as:

·       Infection. This is a more common issue, but it can typically be resolved without any treatment.

·       Haemorrhaging (bleeding). This is an unusual risk (1:100 women need additional surgery).

·       Diathermy uses electricity which may short circuit causing a burn. This is generally spotted straight away, but can take several days to become noticeable (< 1:100 women).

·       Pap (cervical) smears. If cervical stenosis occurs, the cervix may not extend sufficiently during child birth which will result in a C-section (Caesarean section) (< 1:100 women)

·       It may also be likely that the cervix may not expand sufficiently during labour, necessitating a C-Section (Caesarean Section) (< 1:100 women).

A few risks or problems can arise after genital wart removal. These include:

·       The reappearance of warts. A potential virus infection can be the cause of warts, which may trigger their resurgence.

·       There is an open wound following wart removal which may take a while to heal.

·       The region where the wart was removed is thickened with some discolouration and discomfort in the scar.

After a cervical cone biopsy, some of the risks/problems can include:

·       Bleeding: It is quite common for bleeding to appear after this operation. It can occur in several hours or up to the first 10-12 days. Statistics show that less than 1:10 women suffer from bleeding resulting in additional surgery.

·       A common manifestation is ‘vaginal infection’ which generally resolves itself without any treatment, although antibiotics may be necessary. It is feasible that such an infection can spread to the ovaries and pelvis. Although rare, if it occurs, you may have difficulties in the future when becoming pregnant.

·       Cervical Smears (PAPS). This happens following cervical stenosis where the cervix does not widen sufficiently during labour, resulting in the need for a Caesarean section (< 1:100 women).

·       After the operation, it is possible for the cervix to be more open than normal. When this arises the cervix can become less firm, and as a consequence, mid-pregnancy miscarriages may result, although this is uncommon (< 1:100 women).

Following vulva, perianal or perineum regions, there may be a few possible risks/problems, which can include:

(a)   The areas that have been treated can be sore for a few weeks. They rarely remain painful for several months.

(b)   Bleeding or infection in the wound before healing has completed.