A high grade squamous intraepithelial lesion is noted with pap, next management includes -

Ans' is'c'i.e., Colposcolic study and biopsyFor high grade intraepithelial lesions (HSIL), first step is to do colposcopy and biopsy. Moderate to severe dysplasia(CIN-II & CIN-III) (HSIL):Treatment options are:Local destructive methodsCryosurgeryFulguration/electrocoagulation .Laser ablationExcision of abnormal tissueCold knife conisationLaser conisationLLETZLEEPNETZSurgery:Therapeutic conisationHysterectomyHysterectomy with removal of vaginal cuff if carcinoma in situ extends into vaginal vault