Treatment of choice of stage III CIN in 40-year-old female is:
Correct Answer: Hysterectomy
Description: As discussed in preceding text - management options in CIN are
Ablative techniques like cryosurgery, laser vaporization therapy
Excisional methods - like LEEP (Loop electro excisional procedure) or LLETZ
(large loop excision of transformation zone), condition surgery
Hysterectomy
In general, the major drawback of ablative procedures is - it destroys the tissue and so no tissue specimen is available for additional histologic evaluation during follow-up.
Cryotherapy:
It should be considered only if. There is a minor degree of CIN localized and it is
"This method is ideal for minor degrees and localized CIN" - Dutta 6th /ed p 327
Thus in this patient - cryotherapy will not be done as she has CIN III
Laser ablation:
Rarely used in practice. Used only if CIN extends to vaginal fornices.
Remember
Most early CIN is now managed expectantly so the need for ablation is decreasing."
Hysterectomy:
As far as hysterectomy is concerned - it is taken as too radical a procedure for management of CIN and is reserved for special circumstances like recurring CIN -
Recent management says whether the patient is young or old -CIN111 should be managed by LEEP/LLETZ.
Category:
Gynaecology & Obstetrics
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