A 35-year-old woman with CIN 3 on colposcopy-directed biopsy has a satisfactory colposcopy with the lesion entirely visible. She is 24 years old and nulliparous. Which is the most appropriate management?
- A Cold knife conization or LEEP ✓
- B Total abdominal hysterectomy
- C Cryotherapy
- D Radical trachelectomy
Correct answer: A. Cold knife conization or LEEP
Explanation
CIN 3 in a young woman with satisfactory colposcopy is managed with excisional procedures (cold knife conization or LEEP) to exclude invasive carcinoma and provide definitive treatment. Cryotherapy is not recommended for CIN 3 as it does not provide a specimen for histological assessment. Hysterectomy is overtreatment for preinvasive disease. Radical trachelectomy is for invasive cancer.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
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Written and medically reviewed by the StethoPrep medical team.