Hmmmm....they didnt tell me any of those. I always have a nurse call to give the results, and this past time she said I had low grade abnormal cells and I would need a colposcopy to get a "better idea" of what is going on.
When they called with the results of the colposcopy, I was told, nothing is wrong, just repeat pap in 6 months.
And I know it is an important exam, so I will continue to go, but I hate having to get one every year. And when it continues to come back negative, I wonder what the difference between just repeating the pap or going straight to colposcopy?
I guess I need to ask more questions next time.
I know that HPV is a precursor for cervical cancer, but would that automatically require you to have yearly colposcopies?
This link is the American Association of Colposcopy and Cervical Pathology. I hope you can see these algorithims, and hopefully they make sense. (CIN stands for cervical intraepithelial neoplasm - it is just a different nomenclature for biopsy specimens so CIN I would corespond to a low grade pap and CIN2/CIN3 to a high grade pap)
Being HPV + is just another clue. Your body can fight off the HPV or the HPV can become incorporated into your cells and be a potential problem.
I'm a OB/GYN nurse.
Whether or not you have HPV plays a large role in how your case is handled. If you have ASCUS with positive HPV, that would indicate need for a colpo. If your colpo came back with any grade dysplasia, we would do a LEEP. If your LEEP margins are clear, we do paps every 3 months for a year, then every six months for a year, and if they continue to be negative, you go back to annual paps. NEVER in your case should you go longer than a year without paps. The guidlines for paps every 3 years DO NOT APPLY IN YOUR CASE.
If you have ASCUS with a negative HPV test we would repeat your pap in 3 months. If your next pap was abnormal, we'd do a colpo, and then a LEEP if necessary based upon your colpo pathology (if abnormal).
If your pap came back with mild, mid or high grade dysplasia, regardless of HPV status, you get a colpo.
If my physician were handling your case, by this point with as many abnormal paps as you've had, you'd have probably been scheduled for a LEEP by now. My doc is extra conservative and careful, so that doesn't mean what your physician is doing is necessarily wrong. A LEEP is a relatively minor procedure and gives us a great deal of relief when negative.
What it sounds like is that you've not tested positive for HPV. That doesn't mean you DON'T have HPV. The percentage of the sexually active population with HPV is roughly 80-90%. If you've had at least 2 partners, you've been exposed based upon statistics.
Sometimes bacterial infections will cause inflammation that will cause a pap to read abnormal. Usually the cytotechnologist will mention cervicitis in this case and you'd get treated with antibiotics and have a pap re-done in 3 months.
If you feel you've been poorly managed, I'd recommend a second opinion. But please take your physician seriously when they want to see you back in the office!
I have had a few colposcopies and they have saved my life. When i was 20, I had an irregular pap, had the colposcopy and it came back with pre cancer. I had surgery to remove part of my cervix (cold knife cone?). I will willingly have colposcopies done in case of pre cancer or cancer again.
Same here, but I was 29 and my cone (LEEP) was done by cauterization.
OP, I would imagine there has to be a reason they are doing so many? What does your OB/GYN say when asked?
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