Laser Treatment The CO2 laser is still used to treat abnormal cells on the cervix and vagina, but usually only in selected cases. This does not imply that the abnormality is more severe, but it tends to be reserved now for more rare problems such as abnormal areas of skin at the top of the vagina. This may be combined with a loop excision of the central part of the cervix. The laser is safest if used under a short general anaesthetic. Cone Biopsy This is sometimes used to diagnose and treat specific problems involving the birth canal of the cervix. A deeper core of tissue is taken from around the cervical canal either using a larger loop or a specially shaped scalpel. There is a small risk of bleeding afterwards and hence the medical and nursing staff will keep you in until they are happy that this has settled completely. After Treatment These methods of treatment leave a burnt or raw cut area on the cervix which needs to be allowed to heal. It usually takes three to four weeks to heal up, and during this time you will notice a blood-stained or brown discharge, or some spotting. The discharge usually becomes more watery with time and eventually stops. A panty-liner is usually required. You should not use tampons until the discharge has settled completely. You will probably experience some period-like pain shortly after the treatment as the local anaesthetic starts to wear off. Some simple pain killers such as Paracetamol or Ibuprofen may be required. You should leave the cervix undisturbed to promote healing. During the first few days after treatment it is recommended to avoid heavy lifting or rigorous exercise such as horse-riding, cycling running or skiing. It is fine to have a bath or shower immediately. However, swimming should be avoided until the discharge has settled down. Equally, you should avoid sexual intercourse until the discharge has reduced also and do not use tampons for your next period. Possible Complications of Treatment Approximately 5% of people develop an infection during the healing phase. This usually causes an offensive discharge or vaginal bleeding at a time when you are not expecting your period. If you notice either of these or you have any other concerns regarding the treatment you should either contact your place of treatment or your GP for a prescription of antibiotics. Very rarely bleeding may be very heavy and require assessment by a doctor and possible hospital admission. This may require treatment with intravenous antibiotics and insertion of a vaginal pack to apply pressure on the cervix or further treatment measures to control the bleeding under anaesthetic. For my patients I may always be contacted for advice via my private secretary: Tel 01483 555816 Or for NHS patients via the Colposcopy Clinic or my secretary at Crawley Hospital: Tel 01293 600300, or at the Royal Surrey County Hospital Tel: 01483 571122. Follow-Up after Treatment Cervical smears are used for follow-up after treatment. Sometimes a repeat colposcopy examination is also required at six months when your first follow-up smear is due. The frequency of follow-up visits depends on the grade of abnormality and your precise laboratory results. For women with low grade abnormalities such as CIN1 follow-up smears are usually recommended at 6, 12 and 24 months after treatment. After that if all are normal you may return to the usual NHS screening call-up programme. For more severe abnormalities such as CIN2 or 3 a first follow-up smear is performed at six months, and then annual smears are recommended every year for ten years. Smoking Giving up smoking is a positive way in which you may help yourself to prevent further smear problems. Smoking has been identified as a major risk factor in the development of abnormal smears and also in the development of cervical cancer. Free help and advice on stopping smoking is available through the NHS.