Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is colposcopy?
- Why is colposcopy done?
- How is colposcopy done?
- What special tests are done during colposcopy?
- Acetic acid wash
- Use of color filters
- Biopsy of the cervix
- Based on the colposcopy results, what is the approach to treating cervical abnormalities?
- What should one expect from each of the treatments for cervical abnormalities?
- Carbon dioxide laser photoablation
- Loop electrosurgical excision procedure
- Cold knife cone biopsy
- Colposcopy At A Glance
- Find a local Obstetrician-Gynecologist in your town
What should a patient expect from each of the treatments for cervical abnormalities?
Carbon dioxide laser photoablation
This procedure, which is also known as CO2 laser, uses an invisible beam of infrared light. The laser actually vaporizes the abnormal area. Lidocaine, a local anesthetic, is given to numb the area prior to the laser treatment. A chemical is applied afterwards to prevent delayed bleeding. A substantial amount of clear vaginal discharge and spotting of blood can occur for a few weeks after the procedure. To improve healing, sexual intercourse and tampon use should be delayed for several weeks.
The complication rate of this procedure is very low, about 1%. The most common complications are narrowing (stenosis) of the cervical opening and delayed bleeding. Disadvantages of this treatment include that this procedure does not allow sampling of the abnormal area and is not satisfactory for treating cervical cancer. It is useful, however, for milder dysplasia. It is generally not considered safe for use during pregnancy.
Cryocautery is a relatively simple procedure that uses nitrous oxide to freeze the abnormal area. This technique, however, is not optimal for large areas or areas where abnormalities are already advanced or severe. After the procedure, patients can experience a significant watery vaginal discharge for several weeks. To improve healing, sexual intercourse is best avoided for several weeks.
Significant complications of this procedure are rare and occur in about 1% of patients. They include narrowing (stenosis) of the cervix and delayed bleeding. Cryocautery does not allow sampling of the abnormal area and is generally felt to be inappropriate for women with advanced cervical disease. Thus, this procedure is not satisfactory for treating cervical cancer, but is useful for milder dysplasia.
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