advice please

I have been undr the hospital for the past 4 years for CIN1 changes with HPV; after the last colposcopy I was advised this is now CIN2 and I was asked to attend to discuss treatment options.  Now heres my issues...  

I am 40 years old and due to treatment for rheumatoid arthritis, I have a compromised immune system, I am very clear that my family is complete (my baby is 18 and off to uni) and I have witnessed my (younger) cousins struggle with cervical cancer and treatment (inc. radical hysterectomy).  Today i attended clinic to discuss treatment (as per letter) only to find they expected to do treatment there and then - it was evident that no discussions on treatments was planned to take place.  

I have told the hospital i want a hysterectomy, i have been asking for this the past 4 years, I dont understand why this should continue to be a case of firefighting.  the specialist nurse told me that there is no guarantee lletz would work (although i acknowledge a high percentage do) and that I could end up requiring more treatment.  the hysterectomy would prevent it escalating into cervical and womb cancer but given this is hpv i will still need regular smears - i have no problem with that, i just feel like im playing russian roulette by continual 6 month screening and waiting to see if/when it progresses to cancer.  i dont understand this sytem i really dont.  

anyway i have managed to get the specialist nurse today to refer me to see another consultant for their opinion and so they can hear my views (it is my body after all).  but before i do get there (about 4 weeks time) im hoping for others views/thoughts/opinions on treatments and whether im maybe just being a bit overly cautious?!!  please be brutally honest with me, i wont take offence - you dont need to agree with me just to make me feel better, i need truth and thoughts

thank you in advance xx

Hi Sarah

I can totally relate to feeling like you are firefighting, I almost feel like its inevitable that at some point I will end up with a hyster as that is my only treatment option left if I have a reccurence. However lletz treatment can be totally successful and negate any further treatment in the future, a hysterectomy is a major op and carries a lot more risk. The size of the op aside it also doesnt offer certainty that abnormalities wont persist, thats why they follow up with vault smears. Also something to consider is the function of your ovaries, even if they are left in place the op can lead to them giving up the ghost and causing the menopause, as an arthritis sufferer myself the loss of hormone function is not something I am keen to rush into.