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?'s abnormal paps/cold knife cone ?'s abnormal paps/cold knife cone

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Unread 08-08-2001, 06:03 AM
?'s abnormal paps/cold knife cone

Hi. In July I posted for the first time concerning a hysterectomy recommendation by my doctor for fibroids and endometriomas. Thanks for all the helpful responses. But another, separate issue has come up.

I’m 47 and never had an abnormal pap. 2/01 I had a normal pap by a gyn. 5/4/01 the gyn/onc (the dr. monitoring the endometriomas) did another pap. It came back as “suspicious adenocarcinoma”. 5/2l/01 I had a colposcopy/cervical, endometrial and endocervical biopsies--all were clean. Another cytologist reread the pap and called it an overread, downgrading it to AGUS and was told to have another pap in 4 months. On 7/30 I saw the gyn/onc for an ultrasound and followup for the endometriomas which were unchanged. That day she was scattered and did not even know why I was there. She wanted to redo the pap. I reminded her it had only been 2 months since the last pap, not the originally recommended 4 months, but she said it didn’t matter and did the pap anyway. It came back as reading CINIII. (Shouldn’t this have been picked up on the colpo/biopsies in May?) I feel she should have this pap reread (as she did with the first pap) before proceeding. I asked if this pap could also be an “overread” and she said no. I also wonder if she should of waited the full 4 months after the colp/biopsies to redo the pap to give the cervix more time to heal as could this have skewed the pap results? It took a long time for me to heal--throwing off my periods until just recently. She strongly recommends a cone and D&C. Under the circumstances I feel uncomfortable going straight from the abnormal pap to a cone. I have many ?’s. On Mon. I tried to phone her but was told to use the preop appt. to ask ?’s. Her office refused my request for a consultation prior to the preop. I insisted that the dr. call me and was told they would leave her my message. They could not be pinpointed as to when she’d call me back though the secretary did say maybe on Friday. Am I being unreasonable? I’m in the process of trying to find another gyn/onc for a 2nd opinion.

Please could anyone offer feedback on my situation?

Has anyone had abnormal paps and then a clean colpo/biopsy? If so, what was the next step?

Could having a pap too soon after a biopsy produce an abnormal pap? What is the minimal time period between a biopsy and the next pap?

Thanks. I don’t know what I’d do if I didn’t have Hystersisters to turn to. I am confused and scared.

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Unread 08-08-2001, 06:33 AM
?'s abnormal paps/cold knife cone

Just wanted to tell you what happened to me. I had an abnormal pap in 3/99. The colposcopy biopsy came back benign. I had normal paps every 6 months until March/01, when it came back mild dysplasia. I had 3 colposcopy biopsies that came back CIN3. On 4/27, I had a cold knife cone that came back only mild dysplasia. My dr. forwarded all my slides to a gynecological pathologist, who agreed with pap and cone, yet as for the CIN3 biopsies...????????????. I opted for a TVH because in addition to being done with my family and 39 years old, I have the high risk HPV. YUK!!!

My dr. told me, that after any trauma to the cervix, an accurate pap couldn't be obtained for at least 4 months. I just asked her this on Mon. because I was there for 3 weeks post-op and wanted to know when my vaginal pap( i know the correct term, but I choose not to use it).

I've found, when dealing with my drs. office, if I can get through the gatekeeper, I usually get all the info I need. It took me alot of agonizing days to figure this out.

I wish you luck!! This site is wonderful!!

Please remember this is my experience only, and my opinions, check with your dr about any concerns!!
Unread 08-09-2001, 10:30 AM
?'s abnormal paps/cold knife cone

There is always a chance that pap results are not accurate. I can understand why you wanted them reread. Personally I don't have much experience on this issue, but I can tell you that you NEED to feel comfy with your dr. IF you are not, then remember that you always have an option of getting a second opinion. There is nothing wrong with that, and it may really help you!!
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Unread 08-09-2001, 01:43 PM
?'s abnormal paps/cold knife cone

I can tell you I had paps every 3 mo. after colp/biopsies and a cold knife cone. All my paps came back bad, so I don't know if it's because it was only 3 mo after the procedure or if it's because I have a very aggressive dysplasia.

Sorry to hear what your going through, but can certainly relate!

Take care.
Unread 08-09-2001, 02:05 PM
?'s abnormal paps/cold knife cone

Gee Gayle , you certainly are being given the runaround.

I dont think you should rush into having a cone biopsy. It is so important to get a 2nd or even 3rd opinion .
Sometimes the Drs receptionists make me so angry, what if it was them ? I am sure that they would want as much information as possible especially where all this is concerned.

Please dont forget we are all here to support you .This is a scary thing to be happening and I just want to tell you that we are all here with you . Much love always x x
Unread 08-09-2001, 04:14 PM
?'s abnormal paps/cold knife cone

Hi, Gayle!

Well, here's my story (the short version). In November I had an abnormal PAP. In December I had the colposcopy/biopsy which came back normal. I was not comfortable with that and asked the doctor to continue looking. In January I had a LEEP (similar to cone but with a laser) which came back carcinoma-in-situ. Then I had the TAH in February.

It's really important to feel comfortable with your doc, so if you feel more comfortable getting a second opinion, you should do so. My doctor has typically waited 3 months after biopsies to do a PAP, but after the TAH he said you had to wait 4 months because of the extensive trauma that's done.

And Transplant, I still use the term PAP (rather than vault smear) because that's what my doc uses. I asked him about "vault smear" and he said he'd heard the term used before but they don't use it around here. So I guess different terms in different regions (kind of like pop, soda, soft drink, and coke).

Good luck, Gayle!
Unread 08-14-2001, 05:42 AM
Update/thanks to all!!!

Dear Hystersisters:
Thanks so much for all the posts. The support and information was very helpful and much appreciated.
Finally was able to get a consult with my gyn/onc yesterday. For the very first time she went over my situation in detail, answered all of my questions, and we discussed and agreed upon the next step. She even gave me copies of all my tests and lab reports.
She acknowledged my skepticism over the 2nd abnormal pap due to prior pap "overread." So she suggested having a repeat pap/colposcopy and biopsies in September. I found out that a uterine polyp appeared on my ultrasound last month which is why she recommended the D&C. So I’ll wait on the D&C until next month and if I need to do the cone she’ll do them together.
Thanks and love from,
Unread 08-15-2001, 11:57 AM
?'s abnormal paps/cold knife cone

I had abnormal paps(ASCUS and AGUS) for 4 years with a doc that wanted to wait and see what happened. I switched docs and had an abnormal pap. I then had a colp with biopsies that came back HPV, abnormal but not cancer.He scheduled a cold cone biopsy right away. That also came back abnormal but not cancer. FOr the next year Ihad paps every three months that came back lacking cervical cells. This concerned my doc so I saw a colpo specialist. My cervix was closed with scar tissue from the cone and we are unable to get an adequate pap smear. Also my menses cannot be let out So now I am looking at a hyst.

Long story short, I would look into all alternatives before doing the cold cone. If I had opted for a LEEP, I probably wouldn't have had the amount of scar tissue I do. My doc preferred the cold cone because he feels it is more acurate.

Good luck in what every you end up doing


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