This is a basic overview of currently accepted medical treatments related to the cervix. It's designed to help you understand the benefits and shortcomings of modern medicine, and where SBR fits in relation to them.

HPV vaccine 

Preventative measure against development of cervical lesions. Ineffective once the body is infected with HPV.


LEEP / LLETZ

Cuts away infected tissue and cauterizes the wound. This procedure may increase the risk of incompetent cervix. 

To acquire a proper biopsy, the surgeon often needs to shave off extra tissue (because initial biopsy is charred at edges so doctors may not be able to tell how deep the lesions are). Depth of incision is a significant factor in cervical incompetence.

If you opt for LEEP, request fibrin sealant -- it reduces the incidence of severe post-operative hemorrhage, which is extremely common.

(Diagram referenced from NebraskaMed.com)

Cyrosurgery / Cyrocautery

Destroys abnormal cervical tissue by freezing it several mm deep in all directions. 

Cryosurgery is effective for managing low-grade, single-quadrant cervical lesions, but cure rates decrease sharply as the severity and size of the lesion increase.

(Diagram referenced from Ebix, via University of Maryland)

Conization (cone biopsy)

Surgical removal of a cone-shaped sample of tissue from the mucus membrane of the cervix.  Conization may be used either for therapeutic purposes to remove pre-cancerous cells or merely for diagnostic purposes as part of a biopsy. This procedure may increase the risk of incompetent cervix.

(Diagram referenced from HealthTap.com) 

 Cauterization (Laser, chemical, cyrocautery, electrocoagulation, etc)

Destroying cervical tissue to prevent lesions from spreading. May also be used to stop cervical bleeding that is occuring either spontaneously or following a cervical procedure such as cervical biopsy, cervical polypectomy, or cervical conization.

The most common methods involve high frequency electric current (electrocoagulation) or freezing (cryocauterization, cryosurgery).

Laser cautery was used to vaporize lesions selectively, leaving most of the cervix untouched. However, high recurrence of infection led surgeons to prefer removal of the entire transformation zone. 

Chemical cautery typically involves applying a silver nitrate stick to the cervix. 

Hysterectomy

Supposed to be used when cervical infection is so advanced that it cannot be treated with other options.

However, it is the most commonly performed gynecological surgical procedure. In 2003, over 600,000 hysterectomies were performed in the United States alone, of which over 90% were performed for benign conditions. 

These rates are the highest in the industrialized world and have led to major controversy that hysterectomies are being largely performed for unwarranted and unnecessary reasons.

Oophorectomy (removal of ovaries) is frequently done together with hysterectomy to decrease the risk of ovarian cancer. However, recent studies have shown that oophorectomy without an urgent medical indication decreases a woman's long-term survival rates substantially and has other serious adverse effects. 

(Diagram referenced from Ebix)

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Definitions and Important Trivia

OS - The opening between the vagina and the uterus

Biopsy - A specimen of tissues or liquids from a living body examined to determine the existence or cause of a disease

HPV - Human Papillomavirus, associated with 80% of cases of cervical cancer but not all. There are indications that HPV does not cause cervical cancer directly. Rather, HPV causes cervical lesions, which seem to leave the cervix vulnerable to infection. 

Infertility - A couple's inability to conceive after 12 months of contraceptive-free intercourse. 1 in 7 couples experience infertility. Infertility during secondary pregnancies is extremely common. About 1 in 4 couples experiencing infertility are already parents. Approximately 20% of infertile couples have unexplained infertility. 

Incompetence -  a medical condition in which a pregnant woman's cervix begins to dilate (widen) and efface (thin) before her pregnancy has reached term. Cervical incompetence may cause miscarriage or preterm birth during the second and third trimesters.

Germ Theory - The idea that living organisms are a cause of disease. It is a relatively new idea, first suggested in 1844 by lawyer Agostino Bassi. In 1890, physician Robert Koch published a series of proofs to verify the germ theory of disease. 

If you notice that something is incorrect, outdated, or missing, please recommend fixes or updates to lscrenshaw@gmail.com.

 
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