Atlas of Colposcopy: Principles and Practice

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Treatment by LLETZ – Post-treatment advice and follow-up  

The post-treatment advice and follow-up schedule for LLETZ/LEEP are almost the same as those for cryotherapy or thermal ablation. Antibiotics are often prescribed after LLETZ, although the benefit is not proven. The histopathology report of the excised specimen should be carefully evaluated to see whether there is any suggestion of invasive cancer and whether the margins are positive (affected by CIN). Cases with invasive cancer on histopathology should be appropriately managed or referred. Women with a positive margin on the LLETZ specimen need individualized management. Those with CIN 2, CIN 3, microinvasive cancer, or glandular disease on the inner margin (endocervical and stromal) need evaluation for repeat LLETZ or hysterectomy. Those with CIN detected on the ectocervical margin of the cone need follow-up only. Those with persistent disease at first follow-up after 8–12 months need a repeat excision after carefully ruling out invasive cancer.

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