Pre-cancerous lesions
They can be squamous or glandular.
Depending on the type found by the smear, the management will be different.
A diagnostic time by a colposcopy + biopsy is often necessary.
This examination is carried out in consultation.
- A preparation of the cervix is often proposed (cervicovaginal disinfection, local estrogen).
- The examination consists of observation of the cervix with magnification. A first observation is made "without preparation", then after application of acetic acid, then application of Lugol.
- The appearance of the cervix and its evolution with the different dyes make it possible to identify the abnormal areas and their severity.
- Biopsies are usually performed on the most abnormal areas, in order to obtain a histological diagnosis.
Once the diagnosis has been made, management is defined according to the anomaly identified, the age of the patient, her history, etc.
For example, CIN1 lesions regress spontaneously in more than 60% of cases, in less than two years. Their treatment is therefore not mandatory and monitoring is often proposed.
CIN2 and CIN3 lesions, on the other hand, are more often treated by conization.
Conization is a surgical procedure, most often performed under general anesthesia. More rarely it is possible to use loco-regional anesthesia. Local anesthesia is exceptional today because it is not very effective.
We remove part of the neck, in the shape of a cone. You can use a diathermic loop or more rarely an electric scalpel.
The intervention is brief. The aftermath is not painful, but almost always involves bleeding that will last a fortnight.
Analysis of the cone confirms the diagnosis in the majority of cases. More rarely, it will ultimately show a less serious or more severe lesion (cancer).
Usually this intervention has no consequences on sexual life, fertility, the course of pregnancies, etc. Previously reported complications were seen with surgical techniques that are no longer used.
