CGIN and LLETZ under general anaesthetic

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ashley0402
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Joined: Sun Mar 10, 2013 10:40 pm
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by ashley0402 on Sun Mar 10, 2013 10:54 pm

CGIN and LLETZ under general anaesthetic

Hello there,

I have recently had an abnormal smear result ( severe dyskaryosis ) and had a colposcopy to investigate. My abnormal cells were found to be near the vaginal wall and therefore treatment under local anaesthetic in the same appointment was not possible. I had a biopsy and this returned as CIN 2/3 and low grade CGIN. I have been advised that treatment is needed under a general anaesthetic in an outpatients clinic.


I have found that both CGIN and abnormal cells near the wall are uncommon and therefore it seems as though there is a lot less information out there regarding both. I understand that CGIN is a different tissue, on the inner lining. I have been told that it can be treated in the same way as CIN with the LLETZ procedure.

How will you know if you have gone deep enough to remove all the abnormal CGIN cells if they are found on the inner lining?

Is it a possibility that a cone biopsy could be carried out if needed whilst I am under general anaesthetic to ensure all is removed?


How do you define low grade and high grade CGIN... All I have read is that high grade CGIN is equivalent to CIN3?


Are there any additional risks related to abnormal cells being situated near the vaginal wall in terms of spreading to the wall or from LLETZ?

Sorry in advance for the questions, I feel in the minority.

Many thanks

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Professor Sean Kehoe
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Joined: Mon Mar 04, 2013 1:11 pm
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by Professor Sean Kehoe on Mon Mar 11, 2013 12:57 pm

Re: CGIN and LLETZ under general anaesthetic

will try and answer some at least ..
CGIN as you state is different to CIN and indeed there can be - whats called skip lesions - in other words the specimen taken may undicate all is removed but there could be another abnormlaity hidden higer up the cervix. This is on reason why the' failure' rate in treatment is higher when compared to CIN. But by experience, this is not a mjor problem and the alternative would be a hysterectomy - a major operation and not required by all [as skip lesions are not that common]. All that can be done is to monitor after LLETZ. Doing a cone biopsy is probably not required - the LLETZ now considered sufficient and as good as a knife cone but causes less damage. There will be rare situation whereby a knife cone may well be deemed appropriate.
The fact that there is some areas close to the vagina or on the vagina - means that your follow-up may well include colposcopy or a smear from that area to check all is gone. The main risk of been close to the vagina is that it spreads - but this as I stated above can be monitored.
CGIN is termed high or low grade - high is like CIN2 and 3 and low like CIN 1
Professor Sean Kehoe
MA MD DCH FRCOG

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