Cervical Cancer Screening

Module IV

Techniques for Evaluation of Abnormal

Pap Smear

Treatment of Preinvasive Disease

Techniques for Evaluation of

Abnormal Pap Smear

Colposcopy

Biopsies

LEEP and Cone Biopsy

Dilation and Curettage, hysteroscopy

HysterectomyModule IV

Techniques for Evaluation of

Abnormal Pap Smear

ColposcopyEvaluation of the cervix, vagina, and vulva with a colposcopy after the application of acetic acid 3-5%

Crucial to have appropriate dilation of acetic acid. Less dilute solutions (strength greater than 5%) can cause third degree burns

Module IV

Techniques for Evaluation of

Abnormal Pap Smear

ColposcopyAdequate colposcopy means that the

entire squamo-columnar boundary is

seen or that the full extent of the lesion is

seen.

Module IV

Techniques for Evaluation of

Abnormal Pap Smear

BiopsiesEndocervical sampling involves a

curettage of the endocervical canal

Module IV

Cervical Cancer Screening

Treatment of Preinvasive Disease

Low Grade Preinvasive Disease

Most LSIL will not have treatment

High Grade Preinvasive Disease

Module IV

Treatment of Preinvasive Disease

High Grade Preinvasive Disease

Observation

LEEP

Cone Biopsy

Cryotherapy

Carbon Dioxide Laser Ablation

HysterectomyModule IV

Treatment of High Grade Preinvasive Disease

Hysterectomy

Laparoscopic

Vaginal

Abdominal

Module IV

Simple Hysterectomy

Prevesical space

Paravesical space

Cardinal ligament

Pararectal space

Retrorectal space

Vesicouterine space

Uterosacral ligament

Rectovaginal space

Vesicouterine ligament

CERVICAL CANCER

SCREENING MODULE IV

CONCLUSIONS-This module summarizes the steps to the pelvic exam and

the evaluation of an abnormal pap smear.

-Treatment of preinvasive disease includes fertility-sparing

local ablative techniques and simple hysterectomy for

women who have completed child bearing.