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Tired of going through all this! Tired of going through all this!

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Unread 06-30-2004, 08:48 AM
Tired of going through all this!


I have been through alot over the past year, I had to have a D&C done in August 2003 for a missed miscarriage, then I had an abnormal pap for the second time so the gyno. did a colposcopy and cervical biopsy which came back normal so he had me come in for a pap every 3 months, and yesterday I received a call that I need to have a leep procedure OR a cone biopsy done! I've been researching both procedures and I'm just not sure which one to do. I've also been having problems with bleeding for 12-17 days at a time so he told me at my last visit he would probably need to do an ultrasound. Should I discuss my chance of having a hyster. with my doctor? I would like to hear if anyone else has had these procedures done and their experience. Thank you!
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Unread 06-30-2004, 01:13 PM

HI Michele,
I've had somewhat similar situation, 1yr ago I had an abnormal pap by my general doctor, she told me to go see a gyn. for a colposcopy. I did so and it confirmed some abnormal cells. she said they were so sleight that alot of times your body takes care of them itself so she scheduled me for a pap 6months later to check. in the meantime I too had odd bleeding issues and called her still concerned so she sent me for an ultrasound and they discovered I had multiple fibroids (3 month preg. size) they had nothing to do with the abnormal pap, but did have to do with my bleeding problems. My recent pap came back normal, so my body did deal with those sleightly abnormal cells on its own.
my dr. did do an endometrial biopsy after my fibroids were diagnosed to confirm there were just fibroids in there. That came back ok.
I also had an MRI, and continued to have MRI/ultrasounds on 6month intervals.
I am on this board due to increasing fibroids and have exhausted all other treatment and have to have a hysterectomy. I have some other issues (possible uterine sarcoma) I'm waiting for a test to find out more. talk about stress!
your ultrasound will help determine if you have any other issues
causing any problems. good luck keep us posted.
Unread 06-30-2004, 04:34 PM
Tired of going through all this!

If you've been researching both procedures then you probably already know most of this already.

A leep uses an electric current to "cut" away the end of your cervix. I had two of them and found that aside from the momentary sting of the anesthetic I just jusmped off the table and back to normal life. Had bleeding, etc. for awhile but that's what is supposed to happen. Other ladies have said they felt cramping for a few days afterwards but I didn't have this either time. The down side of the leep is the edges of the tissue sample are destroyed so the "line" where the bad cells end and the normal begins might be not be clear. If they don't see a clear margin they won't know if some of the abnormal cells are higher up or if in fact they got it all.

A cone is far more invasive. They put you under and use a knife to cut. Since its a clean cut they can tell if the margin is clear or if the abnormal cells continue further up and they need to go back and get more. The recovery is harder, more bleeding, usually more tissue is removed. I've never had a cone so I can't tell you about pain or other issues afterwards.

Both procedures are about equally effective in getting the abnormal cells and both have about the same impact on your ability to carry a pregnancy to term. (There's a small chance that your cervix won't be able to carry a pregnancy but it's just a small chance. I got pregnant twice during all this and had no problems. This is a conversation for you to have with your doctor if having kids is an issue.) Why wouldn't everyone choose a leep? It goes back to clear margins.

Most women get rid of the problem with one procedure. If the margins aren't clear another procedure usually fixes it. A hysterectomy is a consideration if the bad cells continue or if they are high up in the cervical canal. Once you've had a couple of procedures follow up testing is harder and then a hyst might be recommended. Taking just your dysplasia and not your bleeding issues into account, it sounds like a hyst is still a long way off.

Must always end these posts with a disclaimer: You must talk to your doctor (and consider a second opinion) to put this all the context of your body, your medical history and your life. Hopefully you will feel good about the decision you reach.

All the best.
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Unread 06-30-2004, 05:17 PM
Tired of going through all this!

Michele: After having my first ever abnormal pap smear in January of this year, I underwent a colpo. with biopsies which indicated severe dysplasia. Because the dysplasia extended into the cervical canal, the Leep procedure was not an option for me. In February, I underwent a cone biopsy (sp?) and a D & C. The cone biospy and the D & C were practically pain free. (thanks to a spinal). These procedures were done on an outpatient basis - taking only 30 minutes. There was no extended time away from work - just a four day weekend. If I were you, I would have the least invasive procedure that will remedy the situation. It seems to me, however, that a cone biopsy would be more effective and you wouldn't have to constantly worry about the dysplasia coming back. Insofar as a hysterectomy, from what I've read here, doctors most often want to do a cone biopsy before doing a hysterectomy just to be sure there is no cancer present. The above is just my opinion - based on my experience only. Tammy
Unread 06-30-2004, 06:13 PM
Tired of going through all this!

With doing the research on the two procedures, the only concern I have is if I do the leep procedure I may have to possibly have the cone done later so why not just go ahead with the cone biopsy and hopefully they will find what they need to and be done with it. On the other hand, the leep procedure would be a better option and I wouldn't have to be put to sleep. I'm pretty much leaning towards the leep procedure but I think I'm gonna call my gyno and talk with him about it. I'm not even really sure how bad the dysplasia is. Thank you all for sharing your experiences.

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