Treatment of cervical intraepithelial neoplasia in outpatient practice

Abstract

Background. the treatment of cin is based on two criteria: colposcopic assessment of the altered area and histological verification -the presence and degree of dysplasia are histological diagnoses. Objectives. To present some destructive (cryodestruction, CO 2 laser vaporisation, radiofrequency ablation) and excisional (LLETZ/ /SWETZ) treatment techniques for cervical intraepithelial neoplasia (CIN), their selection criteria and application in outpatient practice. Material and methods. This is a retrospective study over a period of one year, which included 101 patients with histologically verified CIN. The diagnosis was made after targeted biopsy under colposcopic control or through a see-and-treat strategy. The following methods were applied: video colposcopy, co 2 laser vaporisation using video colposcopy, cryodestruction, LLETZ (SWETZ) under video colposcopic control. Results. Destruction treatment was administered to 46 patients (45.5%). Excision therapy was performed on 55 patients (54.5%). CO 2 laser vaporisation was performed on 20 (43.5%) of the patients with destructive treatment, cryodestruction -on 20 (43.5%), and radiofrequency ablation -on 6 (13%) patients. All patients on excision therapy underwent the LLETZ procedure. After a median follow-up of 2.5 years, no high grade squamous intraepithelial lesion (HGSIL) recurrence was observed. Conclusions. The characteristics of the altered area, the squamous-cylindrical epithelium border and degree of CIN's are decisive for the choice of treatment method -destruction or excision. The role of colposcopy, in this respect, is essential. CINs are successfully treated in an outpatient setting by destructive (CO 2 laser vaporisation, cryodestruction) and excisional methods (LLETZ, SWETZ).