Abnormal Pap and HD Test

My 27 y.o. daughter was just told that some abnormal cells were detected in her Pap smear and they are about to run an HD test and the results will be back in about two weeks. She is very worried, of course, and I am not familiar with any of the conditions that I've been reading about in this forum. I promised her I would ask here and see if anyone has any words of wisdom for her, references or anything.

So what is a LEEP and what is a cone and what are the conditions that they are used for, and just any other info you have to share if you have time? I am looking for info, and wanting to offer some to my dear step daughter. Thanks!

Desk

Hi Desk,

I just had my LEEP about 4 days ago, and it went well. I still don't have the pathology results back, but my doctor seems confident that everything will be okay (like 95%), so I am a bit relieved.

I'm not sure when they perform a LEEP as opposed to a Cone, but basically, in a LEEP they freeze your cervix with local anesthetic (just like the dentist) and then they use a hot electrical wire to remove the bad cells. This is less damaging to the cervix & has less impact on fertility than a Cone procedure. It was REALLY easy! It didn't hurt at all....I was more afraid than anything else. The recovery has been a breeze. I have experienced no cramping, very little spotting......I honestly feel great.

I believe in a cone, you have to be put under general anesthetic and the recovery is a bit longer. In this procedure they remove a cone shaped area from the cervix in order to get the bad cells out. The only problem with this is that it can lead to an incompetent cervix in the future if your daughter still wants to have children. This condition can usually be treated with a cerclage (stitch in the cervix) at 12-16 weeks of pregnancy though if this condition should occur. The likelihood of it happening is only about 1% though, so I wouldn't worry about it too much. Talk to your doctor if you have concerns!

I hope everything works out well for your daughter. I know how scary it is to have this happen at such a young age. Try not to worry too much though because CIN is a highly treatable condition, even at more advanced stages as long as you are committed to your follow up appointments.

Oh.....and CIN is basically diagnosed as either mild, moderate, or severe. This can be assessed using a biopsy, and if it is mild, they may choose to monitor her with paps every 6 months, if it is moderate or severe, it is considered a PREcancerous change, and it will have to be treated with one of the above mentioned methods.

Lisa

Hi Desk,

Here's a that gives some information about the various testing done when someone has had their pap come back abnormal.

Abnormal Pap

Apparently your DD wasn't told what the pap showed, so this may be all premature. Often the patient is instructed to have another pap done in 3 months. I had a Cone Biopsy done back in '89 when my pap showed dysplasia. The Cone took care of it and I had no further problems for 10 years.

I know how hard it is waiting for the results.....sending big 's to your DD.

Hi, (((Desk)))!

There could be so many versions of the next step in this, that it's hard to give you useful information. But I'll share some of my experiences from the past. Now I'm not sure how the HD test is going to impact this, because it's a relatively recent test that they are using.

If a PAP comes back abnormal, but it's just mildly abnormal, the doctor may just say wait it out and come back in 3 months. A couple of times, my doc treated me with an antibiotic (thinking it was a bacterial infection) and then when I went back in 3 months it was clear. If it's clear in 3 months then they'll probably just continue frequent PAP's for a while to monitor this. Sometimes these abnormal cells will resolve themselves. Now, if the HD test comes back positive--assuming that it's a test for HPV as I said in my other post-- then I'm guessing you'll move on to the next step (in the next paragraph).

If a PAP comes back moderately or severely abnormal (and sometimes with mild as well), then it's pretty common practice to do a colposcopy. A colposcope is a microscope that allows the doc to get a good look at the cells on the cervix. The colposcopy itself does not hurt. You're in the same position you are in to get a PAP, but the doc uses the colposcope instead of his eyes to look at the cervix. The doc will put vinegar on her cervix before the exam. The vinegar will make any abnormal cells turn white so that they are easy to identify. If any abnormal cells are detected, then those areas of the cervix will be biopsied (this part is definitely uncomfortable--strong cramping) while your daughter is there in the office. Then you wait around again for 2 weeks while the results come back. If the results come back with dysplasia, then your DD's cervix might be treated with cryotherapy where they use a freezing agent for several minutes on her cervix to kill off the cells, and then she goes home (it's an office procedure).

If there is reason to suspect that the problem is up inside the cervix (instead of or in addition to the external cervix) then a LEEP or cone biopsy is needed. They appear to be using the LEEP more commonly these days because it is less invasive, though a cone is done when they want to take a bigger sample and remove more tissue. Recovery from the cone is more extensive, but I was able to return to work in 2-3 days and felt like my old self within 1-2 weeks. The cone is done under general (or epidural) as an outpatient. Some women have had their LEEP's in the office, some as outpatient surgery. I carried several pregnancies to term after my cone, but my doc did warn me that miscarriage due to an incompetent cervix was possible, so for the first pregnancy following the cone I had weekly visits to watch for any problems.

I don't know if this was helpful or made it more confusing, but here are some other things for your daughter to consider:

Cervical dysplasia is most typically caused by a virus. A strong immune system can help fight this virus. Encourage her to eat well, get plenty of sleep, take a good multivitamin with folic acid (check with the doctor for recommendations), exercise, and pray and/or meditate. All of these things are believed to improve the immune system response.

Good luck to your DD, Desk!

<---- one for each of you!