Treatment of cervical intraepithelial neoplasia: experience with the low-voltage diathermy loop

Eighty patients with cervical abnormalities that were proved by colposcopy were treated with the low-voltage diathermy loop by excision biopsy of isolated lesions (n = 14), excision of the transformation zone (n = 52), or by cone biopsy (n = 14). Treatment was performed at the time of initial assessment with the patient under a local anesthetic. Treatment proved acceptable to patients and minimal discomfort was reported. Primary hemorrhage was not a problem, although secondary hemorrhage occurred in 3.7% of patients. Excision was histologically complete in 85% of cases, and excision was clinically complete in the remaining cases. Diathermy coagulation to the base of the lesion ensured hemostasis and destroyed any residual cervical intraepithelial neoplasia. Follow-up cytologic findings were normal in 91% of patients at 3 months, and colposcopy showed no abnormality in 95% of patients at 6 months. The squamocolumnar junction was fully visible in 91% of patients. Thus excisional techniques with the low-voltage diathermy loop appear to be a viable treatment option for cervical intraepithelial neoplasia.