FURTHER INVESTIGATION AND TREATMENT
Inconclusive smear. If the cytologists are unable to interpret the smear, because of infection, an inadequate sample or cells, or blood cells obscuring the view, they may request a repeat smear fairly promptly.
Treating more extensive disease. If the abnormal area is not completely destroyed by diathermy or laser, or if the area is too big, or if it appears that there is a cancer which is already invasive, other means of treatment will be needed. A ‘cone biopsy’ is a larger biopsy of the centre of the cervix, a bit like coring an apple. It is usually done under general anaesthetic, and may remove all the abnormal tissue.
Laser therapy and diathermy do not affect fertility. The cervix still functions normally after these procedures. Cone biopsies in general do not harm the cervix, although there are some occasional complications, particularly if the lesion which needs to be excised is large. These are fortunately uncommon, and it is usually a safe and effective way of treating cervical dysplasia, and even early invasive cancer.
If cancer has spread into normal tissues near the cervix, more extensive surgery may be required, like a hysterectomy. Radiotherapy is also used in some cases.
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