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Anal Dysplasia

What is Anal Dysplasia?

Anal dysplasia is a condition in which some of the cells within the anus have transformed into abnormal cells. High resolution imaging is needed to detect these abnormal lesions.
Anal dysplasia is not cancer, but it is a pre-cancerous condition. In other words, if the abnormal cells are left untreated, they can turn into cancerous tumors. 
In most cases, anal dysplasia is caused by the human papillomavirus, or HPV.

What are the risk factors?

There are several things that can increase your chances of developing anal dysplasia:
  • Exposure to the human papilloma virus
  • Having several sexual partners
  • Anal intercourse
  • HIV/AIDS infection
  • A history of anal warts, 
  • A history of sexually transmitted infection
  • Taking drugs that suppress the immune system
  • Being over 50 years old
  • Smoking

What are the symptoms?

Anal dysplasia is not always accompanied by symptoms. Also, the symptoms of anal dysplasia may be caused by other conditions, such as anal warts, hemorrhoids of anal trauma.
The following are the most common symptoms of anal cancer :
  • Bleeding from the anus
  • A mass at the opening of the anus
  • Pressure or pain in the anus
  • Discharge of mucus from the anus
  • Change in bowel movement patterns—having more or fewer
  • Increased straining during bowel movements
  • Swollen glands in the anus or groin
If you experience any of these symptoms, it is important to see your doctor to determine if you have anal cancer.

How is it diagnosed?

Anal dysplasia is diagnosed with the use of two tests: an anal pap, and High Resolution Anoscopy, or HRA.
In an anal pap, a swab is used to collect some cells from the anus. These cells are then examined under a microscope to determine if any of them are abnormal.
High Resolution Anoscopy is a procedure that allows a doctor to look at cells within the anus. 
First, a plastic anoscope coated in an anesthetic gel is inserted into the anus. Then a swab coated in vinegar is inserted through the anoscope and into the anal canal. The vinegar will turn any abnormal cells white. 
A colposcope, a tool that provides magnified images. The colposcope provides a clear picture of the anal canal, allowing the doctor to see any abnormal cells.
If any lesions are discovered, a biopsy can be performed during the HRA procedure. A biopsy is the only way to make an actual diagnosis of anal dysplasia. Pain after a biopsy is minimal, and most patients only require over the counter medications like Tylenol or Advil for pain relief.
If a biopsy is performed, the cells will be examined by a pathologist to determine if they represent a low-grade or high-grade lesion. Cancerous cells may also be identified. Low-grade lesions only need to be periodically monitored, whereas high-grade lesions will require further treatment.

How is anal dysplasia treated at URMC?

At the University of Rochester Medical Center, anal dysplasia is treated with Infrared Cautery.
Infrared Cautery (IRC) uses short bursts of infrared light to destroy—or “ablate”—abnormal cells. IRC is performed during an office visit. It is nearly painless and causes minimal bleeding. 
Local anesthetics are used to keep you comfortable during the procedure. No suppositories or enemas are required ahead of time. For many patients, two or three treatments will be needed to ensure that all abnormal cells have been destroyed.
After you have had Infrared Cautery for anal dysplasia, you will need regular anal pap tests or HRA to ensure that you have no further issues.