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Cone or Hysterectomy for CIN3/HPV16 Cone or Hysterectomy for CIN3/HPV16

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  #1  
Unread 01-29-2018, 04:38 PM
Cone or Hysterectomy for CIN3/HPV16

I have been diagnosed with CIN3 and carry HPV strain 16. Dysplasia has been found in my outer and inner cervical canal. My dr has given me two options: cone or vaginal hysterectomy(keeping ovaries). I am done having children and am 38 years old. I am nervous about long term effects (sexual, etc) from hysterectomy but not sure how well the cone will work. This is my first ever abnormal pap and I’ve never had any procedures (leep or cone). I’d love to hear any feedback on people who have been in my similar situation and which choice they made. My concern with cone is that I’ll have to continue to get cone procedures done considering I have hpv 16 and CIN3 (this all appeared in six months time so it’s aggressive) Then eventually have to do hysterectomy anyways. Did anyone here jump straight to hysterectomy after an initial diagnosis like mine?
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  #2  
Unread 01-30-2018, 05:08 PM
Re: Cone or Hysterectomy for CIN3/HPV16

Yes, I have exactly the same thing as you. CIN 3 and HPV 16. I have been battling this for 14 years. I had a Leep procedure 14 years ago and have had mostly normal paps until last year. Please note 14 years ago, I didn't have CIN 3 or HPV 16. I had HPV, but not high risk and low grade cervical dysplasia. In December my pap came back with CIN 3 and HPV16. My Dr. wanted to do a Leep. I wanted to just have a hysterectomy. She agreeded and now I'm 6 days post op. I kept my ovaries. I am waiting to hear from pathology to see if the dysplasia went any further then my uterus. I just wanted to get this over, I felt that a hysteroctomy was inevitable. I wanted to get one done while I was young and able to recovery faster. I am 42 and done having children. I had a Laproscopic hysteroctomy with the Di Vinci robot. I will let you know when I hear back from pathology.
  #3  
Unread 01-31-2018, 09:38 AM
Re: Cone or Hysterectomy for CIN3/HPV16

Pathology report came back margins negetive for dysplasia or malignancy.
I'm glad to have it out and not be worried about it anymore.
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  #4  
Unread 01-31-2018, 04:09 PM
Re: Cone or Hysterectomy for CIN3/HPV16

Hi! I was in a similar situation. (HPV 16 positive )I have had abnormal paps for 10 years. I would occasionally have a normal pap but typically it would be low grade and I would get a biopsy and that would be it until the next year. This year it came back CIN3 and I decided I wasn’t risking it anymore and am currently one week post op from complete hysterectomy including both ovaries. Pathology came back yesterday and it was only in my cervix. For me this was the best decision. I am 40 and done having kids. I look forward to not having that stress anymore.
  #5  
Unread 01-31-2018, 09:13 PM
Re: Cone or Hysterectomy for CIN3/HPV16



My situation was a bit more advanced with a different cell type, so this decision was made for me. The "good" news is you are catching things at an early stage when there are options available. Here's a good page on cervical dysplasia and treatment options: https://medlineplus.gov/ency/article/001491.htm

One possibility would be to do the cone to confirm your staging and to see if you get clean margins. If you don't get clean margins, a hysterectomy is often recommended, anyway. If you do get clean margins, you could then proceed with close follow-up and go with a hysterectomy if the dysplasia returns. You wouldn't have to continue with repeat cones at that point, unless that was your preference.

A lot depends on your tolerance for the anxiety of possibly waiting for the other shoe to drop. Some ladies prefer to do a less invasive procedure with close follow-up, and some prefer to do the hysterectomy. We always say to do your research, get as many opinions as you need, then do what you feel is best for yourself long term.

  #6  
Unread 02-08-2018, 01:40 PM
Re: Cone or Hysterectomy for CIN3/HPV16

So, my situation is very similar. I am 49. Went for pap in Oct 2017. I admit it had been 5 years since previous pap. Ugh. Will never let that happen again! Long story short, pap results CIN III, and HPV 16. Dr. performed internal ultrasound, and colposcopy. Ultrasound shows thick uterine lining, colposcopy was normal. Colposcopy incl. 3 areas of biopsy to include a blind endocervical snip. So, now we have a CIN III pap, and a normal colposcopy. So, Dr said next step is a LEEP. LEEP performed Jan 3, 2018. LEEP results confirmed CIN III with free floating squamous cells in endo cervical .......Now, he says based on my age, I should have a hysterectomy. Have gyn oncologist on Feb 9th. My question is why can't we treat this more conservately? I'm scared of having a hysterectomy.
  #7  
Unread 02-09-2018, 08:17 PM
Re: Cone or Hysterectomy for CIN3/HPV16

  Quote:
Originally Posted by Redheadhc10 View Post
So, my situation is very similar. I am 49. Went for pap in Oct 2017. I admit it had been 5 years since previous pap. Ugh. Will never let that happen again! Long story short, pap results CIN III, and HPV 16. Dr. performed internal ultrasound, and colposcopy. Ultrasound shows thick uterine lining, colposcopy was normal. Colposcopy incl. 3 areas of biopsy to include a blind endocervical snip. So, now we have a CIN III pap, and a normal colposcopy. So, Dr said next step is a LEEP. LEEP performed Jan 3, 2018. LEEP results confirmed CIN III with free floating squamous cells in endo cervical .......Now, he says based on my age, I should have a hysterectomy. Have gyn oncologist on Feb 9th. My question is why can't we treat this more conservately? I'm scared of having a hysterectomy.
Yes, there are more conservative treatments for CINIII (check the Medline page link a few posts back), although I'm not certain how much the "free floating squamous cells" tips the scales. Hopefully, the gyn/onc was able to answer your questions at your appointment today. The "good" news is you're catching things at an early stage when there are options and successful treatments available.
  #8  
Unread 02-09-2018, 08:35 PM
Re: Cone or Hysterectomy for CIN3/HPV16

I was scared as well. I'm the biggest baby you will every meet! I am now 16 days out and feel great! It was not nearly as bad as I thought it would be. Just make sure you have skilled surgeons. The rough part was the first 5 days, after that, I felt so much better and will never have to worry about cervical dysplasia again! To me, it was well worth it. Everybody is different, Hugs to you and just make an informed decision.
  #9  
Unread 02-12-2018, 02:43 PM
Cone or Hysterectomy for CIN3/HPV16

So, thank you so much for your replies. My Oncologist said that the floating cells are very high in the endocervical canal. Basically, she said I could potentially already have cancer. She won't know until Uterus goes to pathology. Surgery scheduled for March 20. I didn't want to have it but now I feel lime have no choice. I'm going to leave my ovaries. According to my blood work they are fully functional.
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