TREATMENT
HSIL lesions found on biopsy require treatment. LSIL may be followed by paps and anoscopies every 6 months to one year The current mainstay treatments for HSIL are surgical cold-scalpel excision of dysplastic lesions under anesthesia or laser excision. More extensive lesions often require multiple surgeries as do circumferential disease. The procedure is not free of complications. Post-operative pain is sometimes difficult to control and may persist for up to two weeks. Anal stenosis and incontinence have also been reported. At UCSF, 500 such anal surgeries have been performed to date with only one reported complication (post-operative hemorrhage). They have not reported any stenosis, infections, or sphincter compromise [1]. Other treatment options for smaller lesions include topical chemocauterization with 75-90% tichloroacetic acid (TCA) and electrocauterization [13]. |
