WOMENS-HEALTH Messages for July, 2000: Differing PAP results

Differing PAP results

From: Amanda (anonymous@obgyn.net)
Tue, 18 Jul 2000 20:16:08 -0500 (CDT)

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I will apologize in the beginning for the length of this question but I think the detail is needed in order to understand my question.

Prior to May I have never had any form of irregular PAP's and I have been having them performed yearly since 1989. In May my PAP came back with HSIL and my general practitioner performed a colcoscopy and 6 punch biopsies. During the colcoscopy I had extreme inflammation and infection. My doctor prescribed Cleocin for a total of 14 days. The punch biopsies were performed "blind" because of all the inflammation - the doctor could not see what areas looked suspicious. The result of some of the biopsies was HSIL.

Once the infection was cleared my GP performed punch biopsies on the 3 places that looked suspicious. All 3 of the biopsies only came back with inflammation. My GP sent me to a gynecologist.

The gynecologist also performed one punch biopsy on the area that looked suspicious, repeated the pap and asked for their lab to relook at the original slides. The result of the one punch biopsy only showed inflammation, the repeat pap showed ASCUS and their lab confirmed the original biopsies reading of HSIL. The doctor has recommended a LEEP that I will be having next week. (Note: At no time have any of the tests shown indication of HPV).

My questions are as follows:

1. How could I go from having absolutely NO form of dysphasia to HSIL in 12 months?

2. I understand that if the original biopsy shows HSIL that a LEEP should be performed but I am confused about all of the other biopsies performed. How will the doctor know what area to biopsy with the LEEP when all of the "suspicious" looking areas came back with inflammation only?

2. The second PAP result confuses me. If I truly still have HSIL why would the second PAP not say HSIL instead of ASCUS? How can I trust the PAP that I will have 3 months after the LEEP to be accurate if this second one is in direct conflict with the first?

Thank you in advance for your help with my questions.

--
Amanda

Next message: Harvey S. Marchbein, M.D.: "Re: 6 weeks, 2 days (gestational), 19.9 mm x 17.4 mm sac, no fetal pole"
Previous message: Harvey S. Marchbein, M.D.: "Re: Fibroids/Chronic endometritis"

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