|Electrocautery or Infrared Coagulation for Treatment of HSIL|
Introduction: Electrocautery (EC) or Infrared Coagulation (IRC) has been shown to be an effective treatment for internal anal warts, low-grade (LSIL) and high-grade (HSIL) anal intraepithelial neoplasia. The treatment involves the application of a hand held tip directly to the abnormal lesions. The heat source destroys the surface cells, which can then be removed. It can be done as an office treatment with minimal discomfort. Post-treatment recovery is brief and there are fewer risks than with surgical intervention. Extensive disease may require additional treatments. A follow-up HRA is scheduled three to six months following the procedure. If there is too much to treat in one session, your treatment may be completed at the next visit.
Pre-treatment preparation & medication: You should try to have a bowel movement prior to your appointment, but no special rinsing out or enema is required. Some patients prefer to have mild sedation before the procedure, but it is usually not required. If you prefer to be sedated, please provide us with the name of your local pharmacy so that a prescription of two 1 mg tablets of Ativan (used for short term relief of tension) can be called in for you. Take one tablet 1 hour prior to your appointment and take the 2nd tablet a ½ hour prior to your appointment. You need to be accompanied to and from your appointment if you use this medication.
Treatment: After signing a consent form to verify that you understand and agree to the destruction procedure, you will be treated with numbing gel (tetracaine/lidocaine/prilocaine) in the treatment area. You will then be injected with more numbing medication (lidocaine) on or near the specific lesions to ensure you are completely numb before beginning the treatment.
After treatment instructions: Depending on the extent of the treatment, most, but not all people will have some mild to moderate discomfort which can last a few days and up to 7 to 10 days following the treatment. Most of the discomfort is associated with bowel movements.
Post-treatment discomfort and bleeding varies from patient to patient and may last for several weeks. Please communicate with me if pain relief is not achieved through medication or other comfort measures mentioned above, or if you are experiencing heavy bleeding.
It may take several treatments to clear the precancerous lesions. HPV can come back causing further problems. You may not need more treatment now, but there is also a chance that a problem could develop in the future. Please keep all follow-up appointments to insure that you have healed and that nothing else has developed.