No clear margins, hysterectomy a possibility?


My consultant has finally had the MDT meeting after my lletz for CIN3. I had the biopsy results back ages ago but I had been waiting to find out if i needed further treatment. As expected i've been told there were no clear margins and I have to go and see the consultant next week to discuss further treatment. 

I had my lletz under GA and my discharge notes said I have a prolapse which made the procedure more difficult ( i wasnt aware as i have no symtoms). I am wondering if this means that further lletz will be a bit pointless and a hysterectomy would make more sense. I'm 44 if this makes a difference. I would assume if they were just going to give me another lletz I wouldnt need an appt with the consultant. 

Has anyone been offered a hysterectomy for CIN3? To be honest I just want it over with! 

Thanks xx

Hi there, I was diagnosed with CIN3 in April this year (2018) and after a year of hell due to severe domestic abuse (the culprit receiving a sentence of 24 years) and my life being torn apart, I thought....."Well just my luck!!!" I had 2 procedures to illuminate the cancer, to no avail. I was then faced with the decision whether to have a hysterectomy or not. I am 34,single and have no children. I won't lie, it was the hardest choice I have ever had to make and am positive nothing will be tougher.........When push came to shove, my brain and my heart were pickled, so I asked my surgeon what the safest option was - in terms of health and future complications.I was advise that - unquestionably - a hysterectomy was the best thing to do. So I went with it. Honestly, I feel sadness and grief every day....HOWEVER I am cancer free.....If this helps at all, the relief and joy my loved ones feel because that evil disease was caught, is far greater than any happiness over a baby I may have never had......

My OB had said prior to getting my lletz was that if the margins came back "positive" for dysplasia, she would still wait until my six month "cure smear" to check and see what those results show as the cauterizing they do after the lletz will burn away a few more layers of cells and sometimes that's enough to get the remaining abnormal cells. However, I have read from several women that if abnormalities still show up at the 6 month cure smear, sometimes all that is needed is another lletz and then they're in the clear. I would think that a hysterectomy would only be option after a couple lletz treatments and if the results still showed persistent dysplasia but I think that would depend on how large and deep they went during the lletz and if they felt that the dysplasia has progressed too deep to do another lletz, etc. Good Luck! It's quite an awful ordeal to have to go through isn't it? :( 

Thanks for the responses. and yes it is an ordeal! I should be less impatient, as I will find out next week. It just gets frustrating with the not knowing and the waiting.

I guess I was wondering at what point they decide that there's no point just keep doing lletz when they could do a hysterectomy. I dont particularly want one  but neither do I want this to carry on indefinitetly...


Hi Meraud

I had a Lletz which came back no clear margins my consultant said he would repeat it, he called it a ' top hat procedure because of the shape of the 2 sections removed. He said that if they got clear margins with the second Lletz he would be confident that a hysterectomy wouldn't be needed. Sadly the second also came back no clear magins so I had surgery and I am well on the mend now. Good luck take care I will be thinking of you x

Hi Cherryelm

Thanks for the kind words. It sounds like you've been through a lot. I'm glad you are on the mend and that you dont need any further treatment xx

Hey All,

I think the hyserectomy is offered at the point that keeping the womb for the hope of one day giving birth causes too high a risk.  This was the case with me.

The Pro's of a hysterectomy very sadly outweighed the Con's, and I had to accept that even if I did one day fall pregnant, the chances of me carrying to full term and giving birth to a healthy child would be slim.  Please don't get me wrong, I would love my child no matter what, however I did not think it fair to run the risk of trying to have a baby knowing he/she would suffer.

I hope this makes sense?!?!?

Big Love to you

Update for other people in the same situation.

I saw the consultant today and he's recomended a repeat lletz procedure. So no hysterectomy.  

Hi Meraud,

I was told quite early on I might have to have a hysterectomy as I had a large area of high risk CIN 3 cells. In my case I went through loop, Lletz, two cone biopsies and finally a hysterectomy as each time it hadn't quite cleared the margins. That was over a 3 year period, so there are a lot of steps you can be offered beforehand. 

It's not an easy decision and everyone's circumstances are different but I'm glad I had mine. 

Hopefully your next treatment works and you can avoid it.