When conventional removal is not enough
In a typical situation, the coil is removed by pulling the antennae - this takes a minute and is almost painless. But the antennae can be drawn into the cervical canal, come off, or the spiral can become dislodged and partially embedded in the wall of the uterus. Then a special hook is used under ultrasound control. Before the procedure, the position of the IUD must be clarified by ultrasound: if the IUD is outside the uterine cavity or has grown into the wall, hysteroscopy is required. The procedure can be painful, so local anesthesia is used or it is performed immediately after menstruation, when the cervical canal is more pliable.
Cervical pathology: why it is important to treat
Changes in the cervix are asymptomatic for a long time. Moreover, this is where one of the few types of cancer develops that can be completely prevented, provided that precancerous conditions are detected and treated in a timely manner.
The human papillomavirus plays a key role: oncogenic types of HPV cause dysplasia, which, if left untreated, can turn into cancer over the years. Therefore, the modern approach is based on the combination of “cytology + HPV test + colposcopy”, and treatment is prescribed according to the results, and not “by eye”.
Key interventions
- coagulation - destruction of the superficial pathological area
- conization - excision of a cone-shaped section of the neck with capture of the canal
- extended conization - larger volume when the process spreads into the canal
- removal of condylomas and papillomas with HPV infection
Histology is required
During conization, the removed tissue is necessarily sent for histological examination. It shows the true extent of the changes - often more pronounced than according to the biopsy - and confirms that the pathological area has been removed within healthy tissue. Further surveillance tactics depend on this.