Ablative Methods for Treatment of Intraepithelial Lesions

  • Shruti Bhatia


High-grade intraepithelial lesions are premalignant conditions. If left untreated, they can progress to frank malignancy, and therefore some form of treatment is always indicated for these lesions. Traditionally, surgery including hysterectomy, conization, or wide local excision was considered the standard of care. However, with advances in our understanding of the natural history of human papillomavirus infection and widespread use of colposcopy, conservative management of these lesions is now possible. Treatment options have now evolved to local ablative procedures for intraepithelial lesions of the cervix, vulva, and vagina. Cryotherapy is the most widely used ablative method for treating cervical intraepithelial lesions confined to the ectocervix. Laser ablation, though expensive and not commonly available, is very effective for cervical lesions extending to vaginal fornices and also for vaginal and vulvar intraepithelial neoplasias. Thermal coagulation is another tool which is gaining popularity now owing to its portability and ease of use. In this chapter, we describe the different ablative treatment options for intraepithelial lesions and their applications in clinical practice.


Cervical intraepithelial neoplasia Cryotherapy Laser ablation Thermal coagulation Vulvar intraepithelial neoplasia Vaginal intraepithelial neoplasia 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Shruti Bhatia
    • 1
  1. 1.Department of Gynaecological OncologyAction Cancer HospitalNew DelhiIndia

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