Electrosurgery
Diathermy
Cervical Intraepithelial Neoplasia
Cervix Uteri
Frozen Sections
Colposcopy
Dilatation and Curettage
Uterine Cervical Dysplasia
Laser Therapy
Carcinoma in Situ
Vaginal Smears
Conization of the cervix using harmonic scalpel. (1/39)
Conization, as a surgical treatment for cervical intraepithelial neoplasm (CIN), is a good method that preserves reproductive functions. Technological developments have introduced a wide variety of energy sources for surgical procedures. Traditional cold knife conization has been replaced by laser conization and by the loop electrosurgical excisional procedure (LEEP). However, laser conization and LEEP have some disadvantages. Laser conization requires expensive equipment. LEEP induces electrocautery artifacts and cannot excise the cervical tissue as a single-piece, because of the various extensions and depths of lesion, so that evaluation of the margins is sometimes not possible. Laser conization and LEEP both generate smoke. The presence of smoke is not only inconvenient, but also dangerous. Harmonic Scalpel (HS), ultrasonic cutting and coagulation system, is a new surgical tool that cuts and coagulates using ultrasonic mechanical vibrations. Eleven women with CIN III underwent conization using HS. HS eliminated the major disadvantages of electrosurgery and laser surgery. No complications during conization were observed. Postoperative hemorrhage was noted in only one patient. Histological diagnosis was not affected by heat or ultrasound. This surgical method using HS is characterized by negligible bleeding, a good visual field not obscured by smoke and resection of an ideal shape that fits the size of the lesion. It is concluded that this method overcomes most problems associated with conization using conventional methods. (+info)Evaluation and management of the AGUS Papanicolaou smear. (2/39)
Atypical glandular cells on Papanicolaou smears are an unusual but important cytologic diagnosis. The Bethesda system classifies atypical glandular cells of undetermined significance (AGUS) as glandular cells that demonstrate nuclear atypia appearing to exceed reactive or reparative changes but lacking unequivocal features of adenocarcinoma. AGUS occurs in approximately 0.18 to 0.74 percent of all cervical smears. Because of the high likelihood that AGUS is associated with significant clinical disease, simply repeating the Papanicolaou smear is not sufficient for the management of AGUS. Unlike women with atypical squamous cells of undetermined significance, a significant percentage of women with AGUS will have more serious lesions, such as high-grade preinvasive squamous disease, adenocarcinoma in situ, adenocarcinoma or invasive cancers from sites other than the cervix. Colposcopic examination is recommended for all women with a cytologic diagnosis of AGUS. Those women with AGUS that is suspicious for adenocarcinoma should undergo cervical conization, even in the absence of detectable abnormalities on colposcopic examination. (+info)Conization, frozen section examination, and planned hysterectomy in the treatment of high-grade cervical intraepithelial neoplasia. (3/39)
PURPOSE: We tested the role of frozen section examination of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade cervical intraepithelial neoplasia. METHODS: Twenty-five patients with cervical intraepithelial neoplasia underwent conization followed by frozen section examination and planned hysterectomy. The results of the definitive paraffin exam were compared with frozen section examination. RESULTS: In the evaluation of the margins by frozen section examination, 16 patients (64%) had positive cone margins and 9 (36%) had negative margins. The definitive paraffin examination of margin status was concordant in all the cases. Intraoperative diagnosis of invasion was made in 5 cases, and 1 of these was microinvasive. Among the remaining 20 cases, we detected 2 additional microinvasive carcinomas after paraffin study, so the diagnosis of the frozen section examination was concordant with the paraffin sections in 23/25 cases (92%). Two cases of microinvasive carcinoma were diagnosed as cervical intraepithelial neoplasia by frozen section examination and had less than 2 mm stromal invasion. CONCLUSIONS: In high-grade cervical intraepithelial neoplasia, frozen section examination can provide immediate and precise evaluation of the cone margin status in high-grade cervical intraepithelial neoplasia. It can identify frank invasion and permit adequate treatment in a one-stage procedure. In early microinvasive disease, frozen section examination fails to detect the area of invasion but reliably detects clear resection margins. (+info)Clinical and economic benefit of HPV-load testing in follow-up and management of women postcone biopsy for CIN2-3. (4/39)
This study aimed to evaluate the clinical and economic implications of integrating human papilloma virus (HPV) load testing into the follow-up and management protocol of women postconisation for high-grade cervical intraepithelial neoplasia (CIN2-3). We evaluated 130 suitable women: 63 were screened biannually by Pap smears ('conventional approach') and 67 also had HPV-load testing ('HPV approach'). More stringent criteria for undergoing colposcopy or reconisation were observed by the former group compared to the latter. Both approaches were analysed for cost effectiveness. There were 33 out of 67 (49.2%) colposcopic referrals and 24 out of 67 (35.8%) reconisation/hysterectomies with the 'conventional approach' compared to 9 out of 63 (14.2%) and 7 out of 63 (11.1%) with the 'HPV approach'. Cervical intraepithelial neoplasia 2-3 residual disease was detected in 7 out of 67 (10.5%) and 7 out of 63 (11.1%) women. The 'conventional approach' had more negative colposcopic biopsies and more negative reconisation/hysterectomy histologies than the 'HPV approach'. The respective cost per detection of one case of residual disease was US$3573 and US$3485. The 'HPV approach' required fewer colposcopic and reconisation procedures to detect one case of residual CIN2-3. Its higher positive predictive value than that of cytology provided a significant decrease in false positive rates and a reduction of US$88 per detected case. (+info)Efficacy of cone biopsy of the uterine cervix during frozen section for the evaluation of cervical intraepithelial neoplasia grade 3. (5/39)
We retrospectively selected 22 cases in which patients with a biopsy-proven diagnosis of cervical intraepithelial neoplasia grade 3 underwent cervical conization for frozen section (FS) evaluation followed by hysterectomy at the University of California Irvine Medical Center, Orange, during the August 1995 to September 9, 2001. All slides from FS and permanent section (PS) and hysterectomy specimens were reviewed. FS diagnoses were compared with those of previous biopsies, PS, and hysterectomy specimens. The PS correlated with FS in all cases but 1. Appropriate surgery was performed for all patients based on FS diagnosis. The McNemar test was used to compare the results of FS and PS, with a 2-sided P value of 1.0 and a c coefficient of 0.7755 with a 95% confidence level, indicating that the 2 groups were not significantly different. FS evaluation of cervical conization is as efficacious and accurate as evaluation of regular specimens in providing information for the appropriateness of same-day surgery. We recommend that entire tissue be submitted for FS to avoid sampling errors and to increase diagnostic accuracy. (+info)Transvaginal sonographic evaluation of cervix length after cervical conization. (6/39)
OBJECTIVE: The purpose of this study was to evaluate transvaginal sonographic cervical length before and after cervical conization for squamous intraepithelial lesions. METHODS: Between November 2002 and October 2004, all women undergoing conization by either cold-knife conization or a loop electrosurgical excision procedure for squamous intraepithelial lesions were prospectively enrolled in this study. Cervical length was measured by transvaginal sonography (TVS) before and after conization. RESULTS: A total of 48 women were studied before and after a mean of 7 days after conization. Complete excision was achieved in 41 patients, and endocervical margins were involved in 7 patients. Mean TVS cervical length was significantly shorter after than before conization (mean +/- SD, 22.7 +/- 6.9 versus 26.7 +/- 8.1 mm; P < .001). The correlation coefficient between cone specimen length and postoperative length was r = 0.75 (P < .001). Mean TVS cervical lengths were 24.3 +/- 6.7 mm in the group of women who underwent a loop electrosurgical excision procedure and 20.7 +/- 9.4 mm in the group of women who underwent cold-knife conization (P = .13). CONCLUSIONS: Transvaginal sonographic measurement of cervical length after conization is well correlated with cone specimen length. (+info)High-grade squamous intraepithelial lesion with endocervical cone margin involvement after cervical loop electrosurgical excision: what should a clinician do? (7/39)
This study was undertaken to evaluate the incidence and severity of residual lesions in women featuring high-grade squamous intraepithelial lesion (HSIL) histology with endocervical cone margin involvement after the loop electrosurgical excision procedure (LEEP). The medical records of women undergoing LEEP at Chiang Mai University Hospital between October 2004 and February 2006 were retrospectively reviewed and 74 cases were identified. Nineteen women were excluded because of loss to follow-up. The remaining 4 were referred to other hospitals and 2 declined re-excision, leaving a study population of 55 women for analysis. Mean age+/-SD of the patients was 48.5+/-8.9 years. Residual lesions were noted in 26 (47.3%, 95%CI=33.7 to 61.2). Four (7.3%) had unrecognized invasive cervical carcinoma in subsequent specimens. In conclusion, approximately half of women with positive endocervical cone margins after LEEP for HSIL histology have residual disease. Repeat diagnostic excision is recommended for evaluation of lesions and severity. (+info)Northern Thai women with high grade squamous intraepithelial lesion on cervical cytology have high prevalence of underlying invasive carcinoma. (8/39)
The aim of this study was to determine the underlying pathology of women with high grade squamous intraepithelial lesion (HSIL) on cervical cytology. A total of 681 women with HSIL cytology undergoing colposcopic examination at Chiang Mai University Hospital (CMUH) between January 2000 and December 2005 were evaluated for the underlying cervical pathology. The final pathology was diagnosed from the most severe lesions obtained by punch biopsy, loop electrosurgical procedure, cold knife conization or hysterectomy. Underlying high grade cervical lesions including cervical intraepithelial neoplasia grade 2, 3 and adenocarcinoma in situ were noted in 502 (73.7%) women. Invasive cervical carcinoma was identified in 141 (20.7%). The remaining 38 (5.6%) had either low grade or no intraepithelial lesions. No significant difference in the prevalence of underlying high grade and invasive lesions was noted between women with cytologic diagnosis of HSIL from CMUH and other hospitals. In conclusion, northern Thai women with HSIL cytology are at significant risk of having underlying severe cervical lesions, and especially invasive carcinoma which is detected in approximately one-fifth of the cases. (+info)There are different stages of CIN, ranging from CIN1 (mild dysplasia) to CIN3 (severe dysplasia), with CIN3 being the most advanced stage. The diagnosis of CIN is based on the appearance of the cells under a microscope, and treatment options range from watchful waiting to surgical procedures such as loop electrosurgical excision procedure (LEEP) or cone biopsy.
It is important for women to receive regular Pap smears to detect any abnormal cell changes in the cervix and prevent the development of cervical cancer. HPV vaccination can also help protect against CIN and other types of cervical cancer.
Precancerous changes in the uterine cervix are called dysplasias, and they can be detected by a Pap smear, which is a routine screening test for women. If dysplasia is found, it can be treated with cryotherapy (freezing), laser therapy, or cone biopsy, which removes the affected cells.
Cervical cancer is rare in developed countries where Pap screening is widely available, but it remains a common cancer in developing countries where access to healthcare and screening is limited. The human papillomavirus (HPV) vaccine has been shown to be effective in preventing cervical precancerous changes and cancer.
Cervical cancer can be treated with surgery, radiation therapy, or chemotherapy, depending on the stage and location of the cancer. The prognosis for early-stage cervical cancer is good, but advanced-stage cancer can be difficult to treat and may have a poor prognosis.
The following are some types of uterine cervical neoplasms:
1. Adenocarcinoma in situ (AIS): This is a precancerous condition that occurs when glandular cells on the surface of the cervix become abnormal and grow out of control.
2. Cervical intraepithelial neoplasia (CIN): This is a precancerous condition that occurs when abnormal cells are found on the surface of the cervix. There are several types of CIN, ranging from mild to severe.
3. Squamous cell carcinoma: This is the most common type of cervical cancer and arises from the squamous cells that line the cervix.
4. Adnexal carcinoma: This is a rare type of cervical cancer that arises from the glands or ducts near the cervix.
5. Small cell carcinoma: This is a rare and aggressive type of cervical cancer that grows rapidly and can spread quickly to other parts of the body.
6. Micropapillary uterine carcinoma: This is a rare type of cervical cancer that grows in a finger-like shape and can be difficult to diagnose.
7. Clear cell carcinoma: This is a rare type of cervical cancer that arises from clear cells and can be more aggressive than other types of cervical cancer.
8. Adenocarcinoma: This is a type of cervical cancer that arises from glandular cells and can be less aggressive than squamous cell carcinoma.
9. Sarcoma: This is a rare type of cervical cancer that arises from the connective tissue of the cervix.
The treatment options for uterine cervical neoplasms depend on the stage and location of the cancer, as well as the patient's overall health and preferences. The following are some common treatments for uterine cervical neoplasms:
1. Hysterectomy: This is a surgical procedure to remove the uterus and may be recommended for early-stage cancers or precancerous changes.
2. Cryotherapy: This is a minimally invasive procedure that uses liquid nitrogen to freeze and destroy abnormal cells in the cervix.
3. Laser therapy: This is a minimally invasive procedure that uses a laser to remove or destroy abnormal cells in the cervix.
4. Cone biopsy: This is a surgical procedure to remove a small cone-shaped sample of tissue from the cervix to diagnose and treat early-stage cancers or precancerous changes.
5. Radiation therapy: This is a non-surgical treatment that uses high-energy rays to kill cancer cells and may be recommended for more advanced cancers or when the cancer has spread to other parts of the body.
6. Chemotherapy: This is a non-surgical treatment that uses drugs to kill cancer cells and may be recommended for more advanced cancers or when the cancer has spread to other parts of the body.
7. Immunotherapy: This is a non-surgical treatment that uses drugs to stimulate the immune system to fight cancer cells and may be recommended for more advanced cancers or when other treatments have failed.
8. Targeted therapy: This is a non-surgical treatment that uses drugs to target specific genes or proteins that contribute to cancer growth and development and may be recommended for more advanced cancers or when other treatments have failed.
It is important to note that the choice of treatment will depend on the stage and location of the cancer, as well as the patient's overall health and preferences. Patients should discuss their treatment options with their doctor and develop a personalized plan that is right for them.
There are different types of uterine cervical dysplasia, including:
1. CIN (Cervical Intraepithelial Neoplasia): This is the most common type of dysplasia and is characterized by abnormal cell growth on the surface of the cervix. It can range from mild to severe.
2. DCIS (Ductal Carcinoma in Situ): This type of dysplasia is characterized by abnormal cells growing inside the cervical ducts.
3. AGC (Atypical Glandular Cells): This type of dysplasia is characterized by abnormal cells growing in the glands of the cervix.
4. HSIL (High-Grade Squamous Intraepithelial Lesion): This type of dysplasia is characterized by abnormal cell growth on the surface of the cervix, which can be precancerous.
Uterine cervical dysplasia can be caused by a variety of factors, including:
1. Human Papillomavirus (HPV): This is the most common cause of uterine cervical dysplasia. There are over 100 different types of HPV, and some can cause cancer.
2. Smoking: Smoking can increase the risk of developing uterine cervical dysplasia.
3. Weakened Immune System: Women with weakened immune systems, such as those with HIV/AIDS or taking immunosuppressive drugs, are at a higher risk of developing uterine cervical dysplasia.
4. Family History: Women with a family history of cervical cancer are at a higher risk of developing uterine cervical dysplasia.
Symptoms of uterine cervical dysplasia can include:
1. Abnormal Vaginal Bleeding: This is the most common symptom of uterine cervical dysplasia, and can occur between periods, after sex, or postmenopausally.
2. Pelvic Pain: Women with uterine cervical dysplasia may experience pelvic pain or discomfort during sexual activity.
3. Vaginal Discharge: Abnormal vaginal discharge can be a symptom of uterine cervical dysplasia.
4. Painful Urination: Women with uterine cervical dysplasia may experience pain while urinating.
Diagnosis of uterine cervical dysplasia is typically made through a Pap smear, which involves collecting cells from the cervix to examine for abnormal changes. If abnormal cells are found, further testing, such as a colposcopy (examination of the cervix with a special microscope) or biopsy (removal of a small sample of tissue for examination), may be necessary to determine the severity of the dysplasia and develop a treatment plan.
Treatment for uterine cervical dysplasia depends on the severity of the condition, but can include:
1. Cryotherapy: This involves freezing the abnormal cells using liquid nitrogen to destroy them.
2. LEEP (Loop Electrosurgical Excision Procedure): This is a procedure in which a thin wire loop is used to remove the abnormal cells.
3. Cone Biopsy: This is a surgical procedure in which a larger sample of tissue is removed from the cervix to treat more advanced cases of dysplasia.
4. Hysterectomy: In severe cases of uterine cervical dysplasia, a hysterectomy (removal of the uterus) may be necessary.
Early detection and treatment of uterine cervical dysplasia can help prevent the development of more advanced, and potentially more serious, forms of cancer. It is important for women to follow recommended screening guidelines, such as regular Pap smears, to help detect any abnormal changes in the cervix early on. Additionally, women who have a history of uterine cervical dysplasia should be closely monitored by their healthcare provider and have regular follow-up appointments to ensure that any new abnormal cells are detected and treated promptly.
In conclusion, uterine cervical dysplasia is a precancerous condition that can develop into more advanced forms of cancer if left untreated. Early detection and treatment are key to preventing the progression of this condition. Regular Pap smears and close monitoring by a healthcare provider can help detect any abnormal changes in the cervix early on, and ensure that any new abnormal cells are treated promptly.
Also known as CIS.
Cervical conization
Cervical weakness
Cervical cancer
Trachelectomy
Villoglandular adenocarcinoma of the cervix
Loop electrical excision procedure
Colposcopy
Cervical intraepithelial neoplasia
Medical procedure
Cervical screening
Sexual intercourse
CKC
Index of oncology articles
List of MeSH codes (E04)
List of MeSH codes (E01)
Cervical cancer staging
ICD-9-CM Volume 3
Browsing by Subject "Conization"
A critical evaluation of the Schiller test in patients before conization - PubMed
Cervical Conization - Women's Healthcare Associates
Obstetric outcome following cervical conization<...
June 1, 2000 | AAFP
Cone biopsy: MedlinePlus Medical Encyclopedia
Cervical Cancer Guidelines: Guidelines Summary, Staging, Treatment
Tri A. Dinh, M.D. - Doctors and Medical Staff - Mayo Clinic
Retroperitoneal hematoma - a rare complication after cervical conization because of cervicoisthmic arteriovenous malformation:...
Biomarkers Search
These highlights do not include all the information needed to use GARDASIL 9 safely and effectively. See full prescribing...
Addressing concerns about cisplatin application during pregnancy - PubMed
Lachance JA[au] - Search Results - PubMed
PathoPhys Oncology Flashcards
Atlas of Pelvic Anatomy and Gynecologic Surgery, 5th Edition - 9780323654005
AGUS Pap Smear
New York State Medicaid Update - May 2018 Volume 34 - Number 5
Is It Normal To Bleed After Sexual Intercourse? - Women's Health
Cervical Cancer Quiz: Answer Top Questions
Cervical Cancer Screening/Prevention | Nebraska Hematology Oncology - Cancer Care Treatment Blood Disorders Clinical Trials...
5 Things You Might Not Know About Human Papillomavirus | Blogs | CDC
Colposcopy Digital Atlas
Cervical Cancer India,Cervical Treatment India,Cervical Cancer Surgery
F��lix Boria. Curriculum. Universidad de Navarra
MeSH Browser
WHO EMRO | Case of postoperative haematometra in a 40-year-old woman | Volume 16, issue 2 | EMHJ volume 16, 2010
Knife conization4
- A rare case is presented concerning retroperitoneal hemorrhage in a 28-year-old patient after a cold knife conization and cervical suture reconstruction. (edu.pl)
- Retroperitoneal hematoma: an unusual complication of cold knife conization of the cervix. (edu.pl)
- 13] Larsson G, Gullberg B, Grundsell H. A comparison of complications of laser and cold knife conization. (edu.pl)
- 15] Rimailho J, Puyuelo L, Escourrou G, Hoff J. Value of cold-knife conization without hemostatic sutures. (edu.pl)
Cervix2
- A cone biopsy (conization) is surgery to remove a sample of abnormal tissue from the cervix. (medlineplus.gov)
- The commonest causes include congenital absence of the cervix or vagina and cervical conization. (who.int)
Cone biopsy1
- Cone biopsy (conization). (franciscanhealth.org)
Hysterectomy2
- Objective To evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009). (unav.edu)
- We found a 65% reduction in the risk of relapse for patients who had cervical conization prior to radical hysterectomy (hazard ratio (HR) 0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75% reduction in the risk of death for the same sample (HR 0.25, 95% CI 0.07 to 0.90, p=0.033). (unav.edu)
Margins1
- Are "additional cuts" effective for positive margins in cervical conization? (bvsalud.org)
Procedure1
- Methods: A population-based study was performed comparing pregnancies in women following conization with those who had not undergone the procedure. (bgu.ac.il)
Adenocarcinoma1
- Objective We evaluated the impact of conization margin status on outcomes of patients diagnosed with cervical adenocarcinoma in situ. (sagepub.com)
Abnormal1
- Cervical conization was considered technically unfeasible because of abnormal cervical anatomy (lesions deep in the cervical canal on the cervical bifurcation where the cervical wall is the thickest). (imrpress.com)
Deliveries1
- Results: Out of 104,670 deliveries, 53 women (0.05%) had undergone conization. (bgu.ac.il)
Patients2
- Objective: The purpose of the present study was to examine obstetric outcome of patients following conization and specifically the risk for preterm delivery (PTD). (bgu.ac.il)
- Results We obtained a weighted cohort of 374 patients (187 patients with prior conization and 187 non-conization patients). (unav.edu)
Treat2
- Your healthcare provider may suggest cryosurgery or conization to treat this problem. (home-remedies-for-you.com)
- Conization may be used to diagnose or treat a cervical condition. (stopcancerfund.org)
Delivery1
- One year after this delivery she went ing in the left adnexa about 30 weeks conization. (who.int)