CIN2: Symptoms, Treatment Options, and Recurrence Risks

Cervical intraepithelial neoplasia grade 2 (CIN 2)

Hello Doctor, I was diagnosed with CIN2 last month.
The physician gave me the option of 1.
electrosurgery or 2.
conization, and I chose to undergo conservative treatment with electrosurgery first.
The procedure was on May 10, and I am scheduled for follow-up in four months.
However, as of June 20, I feel there may be signs of recurrence; specifically, I experience swelling after each sexual intercourse since my diagnosis, but after resuming sexual activity post-electrosurgery, this swelling did not occur.
Yet, less than a week after resuming sexual activity, the swelling returned...
This makes me wonder if there is a possibility of recurrence.
Doctor, is it possible for recurrence to happen so quickly? Should I consider returning for an earlier appointment to undergo another biopsy and discuss conization? If it is indeed a recurrence, is it significantly related to the presence of the same HPV virus in my partner? Additionally, I have plans for pregnancy, so I cannot consistently use protection...
Also, if I confirm my pregnancy, I would not be able to undergo conization, correct? If I do not pursue any treatment, is there a risk that it could progress to CIN3, and how long might that take?

Chen, 30~39 year old female. Ask Date: 2023/06/20

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the progression of this condition varies for each individual.
It is recommended to follow up with your physician at the suggested intervals.
If you experience severe symptoms or have any concerns, you may return for an evaluation.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2023/06/20

More Info

CIN2, or cervical intraepithelial neoplasia grade 2, is a precancerous condition of the cervix that is often associated with human papillomavirus (HPV) infection. Understanding the symptoms, treatment options, and recurrence risks associated with CIN2 is crucial for effective management and monitoring.

Symptoms of CIN2
CIN2 typically does not present with noticeable symptoms, which is why regular Pap smears and HPV testing are essential for early detection. However, some women may experience abnormal vaginal bleeding, unusual discharge, or discomfort during intercourse. In your case, the swelling after sexual intercourse could be a sign of inflammation or irritation rather than a direct symptom of CIN2. It’s important to differentiate between post-treatment effects and potential recurrence.

Treatment Options
The treatment options for CIN2 include:
1. Observation: In some cases, especially for younger women, doctors may recommend monitoring the condition, as CIN2 can regress on its own.

2. Excisional Procedures: These include:
- Loop Electrosurgical Excision Procedure (LEEP): This method uses a thin wire loop heated by electric current to remove abnormal tissue.

- Cold Knife Conization: A surgical procedure that removes a cone-shaped piece of tissue from the cervix.

3. Cryotherapy: This involves freezing the abnormal cells to destroy them.

You mentioned that you opted for electrosurgery (電燒) and are scheduled for follow-up in four months. This is a common approach, and many women successfully manage CIN2 with this treatment.

Recurrence Risks
Recurrence of CIN2 can occur, but it is not common within a short time frame after treatment. The risk of recurrence is influenced by several factors, including the extent of the initial lesion, the adequacy of the treatment, and whether the HPV infection persists. If you are experiencing symptoms such as swelling after sexual activity, it is advisable to consult your healthcare provider sooner than your scheduled follow-up. They may recommend a Pap smear or a biopsy to assess for any signs of recurrence.

HPV and Recurrence
HPV is a significant factor in the development and recurrence of CIN lesions. If your partner is HPV-positive, it could contribute to the risk of reinfection. It is essential for both partners to be aware of their HPV status, and vaccination against HPV can be beneficial in preventing future infections.

Pregnancy Considerations
If you become pregnant, certain treatments for CIN2, such as conization, may not be advisable during pregnancy. However, monitoring and managing CIN2 during pregnancy can be complex. It is crucial to discuss your pregnancy plans with your healthcare provider, who can guide you on the best course of action. If you are diagnosed with CIN3 during pregnancy, management strategies will depend on the timing and severity of the condition.

Conclusion
In summary, while CIN2 can be concerning, many women successfully manage it with appropriate treatment. Your symptoms warrant further evaluation, and it is wise to consult your healthcare provider sooner than your scheduled follow-up. Early intervention can help prevent progression to more severe lesions like CIN3. Additionally, discussing HPV status with your partner and considering vaccination can be beneficial for both of you. Always prioritize open communication with your healthcare provider to ensure the best outcomes for your health and future pregnancy plans.

Similar Q&A

Managing Recurrence: Treatment Options for Breast Cancer Patients

Dear Dr. Wu, I apologize for continually bothering you. I have completed my surgery, and 19 lymph nodes were removed, with 17 of them being infected. Currently, my doctor is no longer considering the use of Vinorelbine (he believes it is ineffective) and has suggested using Erib...

Dr. Wu Jingtang reply Breast and Thyroid
Dear Miss Len: 1. Are you planning to pursue aggressive treatment? ---> You should be encouraged! You can rest assured that if chemotherapy becomes intolerable, your physician will pause and make adjustments! 2. After a period of chemotherapy, is it necessary to perform a PE...

Bladder Cancer Stage 2A: Choosing Between MVAC, GP, or TP Chemotherapy?

Dear Dr. Fan, In February, my elderly family member experienced hematuria, and in March, bladder cancer was diagnosed. They were immediately transferred to Ho Shin Hospital, where the doctor indicated that it could be stage II to IV. Subsequently, they underwent tumor resection ...

Dr. Fan Sheng reply Oncology
Mawan: For the postoperative adjuvant chemotherapy of bladder cancer, current data still supports MVAC as the standard regimen. If there are concerns about toxicity, GP can be chosen as an alternative. TP has higher toxicity as well, so it is recommended to consider its use only ...

Understanding Radiation and Chemotherapy for Stage II B Endometrial Cancer

Hello, my mother has been diagnosed with stage II B endometrial adenocarcinoma and will undergo radiation therapy. The side effects of radiation therapy seem quite significant. With the current linear accelerator technology, will there be future issues with bladder function, such...

Dr. Lai Yicheng reply Oncology
1. Regarding radiation therapy: The uterus and bladder are adjacent organs, so part of the bladder may fall within the radiation field, which can lead to difficulties in urination during treatment. These symptoms are temporary and reversible, and will gradually improve after trea...

Managing Chemotherapy Side Effects in Elderly Patients with Rectal Cancer

Dear Director, My father is 84 years old. After the Lunar New Year, he was diagnosed with stage 2B rectal cancer (the tumor is 4 cm from the anal opening). The attending physician assessed that the tumor is too large and recommended six cycles of chemotherapy along with five wee...

Dr. Lai Yicheng reply Oncology
Dear Miss Hsiao-Yun, Thank you for your letter. Here is my response: Your father has a stage 2B malignant tumor in the lower rectum, and there is a possibility for "sphincter-preserving treatment." Based on our experience, preoperative radiation combined with chemother...