WOMENS-HEALTH Messages for May, 1997: Re: Cervical Dysplasia

Re: Cervical Dysplasia

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Fri, 9 May 1997 18:37:22 -0500 (CDT)

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At Fri, 9 May 1997, Ruth wrote: >
>I have a question regarding cervical dysplasia. About two and a half
>years ago, I had an abnormal pap smear. We did a biopsy and found that
>it was mild dysplasia. The doctor suggested that we do the LEEP
>procedure and see if that would alleviate the dysplasia. Initially, the
>next pap came back normal. The following did not. In Novemeber of
>1995, I had a cone biopsy and laser surgery. We thought that this would
>take care of everything. The results showed that the dsyplasia had not
>been present at the upper part of the cervix only the lower end. We
>proceeded to then have a pap three months after and then every six
>months for the past year and a half. All of them came back normal until
>last month. This most recent biopsy, after the abnormal pap, came back
>as moderate dysplasia. I don't understand how is can go in six months
>from normal, all the way to moderate. We are now going to proceed with
>cryotherapy and cautery and see if that will do the job. My question is
>if this does not work, what other options or procedures are there to do.
>I have done some research to find out who is most at risk for dysplasia
>and I don't fit into any of those catagories. My concern is that all
>that we are doing now may affect my ability to carry a pregnancy full
>term. Will this be on ongoing problem that I will have to deal with
>indefinately? Or are there any other procedures? I would appreciate your
>insight on this matter. Thank you.

Hi Ruth, This story is very unusual but by no means helpless. It sounds like you were aggressively treated for the dysplasia and no stone was left unturned.

First, I'd think of having the paps and pathology reports reviewed to confirm that they are not being over or under-read. I'd also do a test called a hybrid capture....a new test which can determine whether or not you have a subtype of human papilloma virus (HPV).

Although lack of virus does not allow you to ignore the pap results, if there is low risk HPV subtypes vs. high risk HPV types, this may help determine more or less aggressive therapy. At colposcopy, I'd also like to know that the vagina is ostensibly clear of abnormalities. (There is currrently no way to see dormant virus without a visual abnormality).

Some centers have done research with Interferon and recurrent HPV. This may be something to look into. If the area of abnormality is small enough to fit easily under a cryosurgery probe, one or two treatments might do very well.

Good luck and give us follow up when it's available.

-- Harvey S. Marchbein, M.D. FACOG, FACS OBGYN.net U.S. Representative, New York Great Neck, New York http://www.obgyn.net/states/bios/marchbein.htm http://www.obgyn.net/women/heroes/harveym.htm

*Note: Opinions expressed here are for educational purpose only. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options.

Next message: Douglas Krell MD: "Re: troubling symptoms"
Previous message: Jerry: "Medicine Availability"
In reply to: Ruth: "Cervical Dysplasia"
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