CHSJ

Curr Health Sci J, vol. 37, no. 4, 2011

Surgical Management of Pre-invasive Lesions of the Cervix

[For Practitioners]

M. MUNTEANU(1), G. ADAM(1), O. SIRBU(1), S. MITROI(1), A. COMANESCU(1), D. ILIESCU(1), S. COTARCEA(1), N. CERNEA(1)


(1)Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova


Abstract:

The natural history of the low grade lesions is most to spontaneous healing, but can also be to persistent lesions and progression to high grade lesions. Unlike the natural history of LSIL, HSIL has a major potential to progress to invasive cancer. The main goal in the management of high grade lesions  must be to remove the entire transformation zone in both surface and depth (7 mm tissue), and that can be achived either by ablation (laser CO2, criotherapy) or excision (ERAD, cold knife conisation, amputation, hysterectomy). Postoperative complications are rare (1-2%) and are typically hemorrhagic or infectious nature. A small percentage of patients may experience some postoperative sequelae: transformation zone ascend, unsatisfactory colposcopy, cervical stenosis, failure of conization.  Obstetrical prognosis is not severely affected after a single intervention, but repeating the procedure may increase risk of infertility and obstetric complications cervico-isthmic (incompetence, premature rupture of membranes, low birth weight, increased neonatal morbidity and mortality due to prematurity)


Keywords: LSIL, HSIL, HPV, ablation, excision, outcome



Corresponding: Munteanu Mihai, MD, PhD, University of Medicine and Pharmacy of Craiova, Str Petru Rares nr. 4, 200456, Craiova, Dolj, RomAnia; mail: mihaimunteanudoc@yahoo.co.uk


DOI 10.12865/CHSJ.37.04.10 - Download PDF
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