So I've been educating myself on cervical cancer, and cervical dysplasia etc., etc. and while browsing webpages about moderate dysplasia (which is what the doctor said I have) I noticed that in the lists of treatments, a cone biopsy (which I've had) was never listed. It was always "Watching and Waiting", cryotherapy, cryosurgery, and LEEP. Is the LEEP procedure basically the same thing as a cone biopsy? I'm just wondering because if I would have known I could have done other things to resolve the issue, instead of jumping right toward a cone biopsy, which possibly causes scarring of the tissue of the cervix, inability to carry a baby to full term because of a weakened cervix, not to mention all the risks I agreed to with surgery and general anesthesia, I would have tried something else first. I hope LEEP and a cone biopsy are the same, or that I just haven't read enough, because I'm pretty annoyed, that my doctor didn't even mention these other treatments. What gives?
Last edited by mod_007; 05-09-2008 at 12:11 PM.
Reason: Please do not use abbreviations for slang (or slang)
I had a LLETZ (which is pretty much like a LEEP) which I was told left less scarring, hence the ability to get pregnant, carry etc. I am pretty certain that the cone biopsy does leave more scarring. It is different, to what extent exactly I'm not sure though.
It isn't right that your dr didn't give you the choice or info. I know here in Australia, they try to go the best way that your condition allows them to. I had mine done with local anaethetic which I'm sure thats how the LEEP is done too. I'm sure there will be some ladies on here who could clarify that though.
It is probably best to take your questions to your dr too. Find out why you weren't given the choice, there could be a good reason. (how much needed to be removed etc)
Sorry to not be much help.
Thanks for replying Mandy, and it doesn't matter whether you Ladies have any information about a particular subject, or not. What matters is that you all are here, and thank you. I was thinking last night after I had posted my message, that maybe my doctor had a good reason to do the cone biopsy, I just unfortunately missed why, considering there were too many things running through my mind for my mind to be able to keep up, but it still doesn't explain why she ONLY mentioned a cone biopsy, but maybe that was really all they could do. I see her Monday, and I hope she's got time because I have tons of questions, and I intend on not "missing" anything this time.
A leep (lletz elsewhere) and a cone are totally different procedures. A leep is a hot wire loop that usually removes less cervix. It's typically used for CIN1, 2, 2-3. Because the wire burns (singes?) the edges of the sample, sometimes clear margins can be difficult to call.
A cone (cold knife cone) is generally reserved for more severe CIN3 and frequently used to treat dysplasia in the canal (glandular). In fact, I think some doctors only use cone for glandular lesions because it's much harder to ascertain what's going on in the canal as opposed to the outer face of the cervix. It's much easier to call clear margins with a cone sample because nothing's burned.
Both CAN cause cervical incompetence, but not always. Obviously the more cervix that is removed the higher the potential.
There is (or was) also the laser, which I personally feel is the best option if the dysplasia is not far advanced, but it's much more expensive, requires anesthesia (I think) and as such is almost never offered anymore.
Brieaukirsch said it wonderfully! My doctor did a cold knife cone. She wanted to be sure the margins could be read. As it is, I *think* my margins for the diameter wasn't great (very little to no margin), but the depth was ok (1mm deep).
Anyway, I think the explaination of margins in spot-on.
Very informative replies Ladies, I know I can always learn a thing or two from you all. Also thanks for explaining the difference between LEEP & Cone
Melgreeneyes- The doctor said I have moderate dysplasia, which is CIN II, right? I'm 24, have no children, and I am HPV positive. So, being that I have moderate dysplasia, I was kind of wondering why the doctor just jumped right toward a cone biopsy after the results of the tissue they had taken from my cervix during a colposcopy came back abnormal.
I'd never heard of any of the other treatments for moderate dysplasia, until I started researching, and like I stated before I feel I agreed to all the risks surgery brings, and the potential possibility of not being able to carry a child to full term unnecessarily, considering that the doctor didn't give me any other alternatives, but then again, she could have had good reasons, unbeknownst to me though.
I won't say that I didn't maybe miss a few things, about why she was specifically going to perform a cone biopsy, but I do know.. no other options were thrown out to me.
Its done and over with now, so theres nothing I can do about it obviously, except learn that I have to tug at that invisible leash around a doctors neck, with question after question, instead of letting them tug me around.