Cervical intraepithelial lesions

A. CIN I. Expectant management is recommended for the reliable patient in whom the entire lesion and limits of the transformation zone are completely visualized. Expectant management consists of repeat cytology at 6 and 12 months or HPV testing at 12 months.

B. CIN II, III, squamous carcinoma in situ. Loop electrosurgical excision procedure (LEEP) is the preferred technique. Ablative procedures are limited to the patient with biopsy confirmed CIN and satisfactory colposcopy.

C. Adenocarcinoma in situ, suspected microinvasion, unsatisfactory colposcopy, lesion extending into the endocervical canal: Cold- knife cone biopsy is the preferred technique.

References: See page 184.

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