WOMENS-HEALTH Messages for November, 1998: Re: Bad paps, and possible LEEP

Re: Bad paps, and possible LEEP

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Fri, 20 Nov 1998 22:36:52 -0600 (CST)

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In reply to: Kris: "Bad paps, and possible LEEP"

At Fri, 20 Nov 1998, Kris wrote: >
>I am terrified now after reading everything on the LEEP proceedure. I had a bad paps, it said
>moderate dysplasia, and high SIL, so I had a biopsy, it was all
>negative, now the dr. wants to have me do laser surgery and biopsy. I
>was concerned about the whole thing so I left town for another dr. who
>will do leep.

Although it is tempting to group all "female" problems into one category, in reality most gynecologic problems are unrelated. For example, ovarian cysts are not usually related to abnormal periods. And, pregnancy terminations are not related to bad Pap smears.

>From what you have told us, it appears your doctor is on the right track
in performing a larger biopsy, such as a LEEP procedure, to determine why your Pap smear is so abnormal. When the smaller biopsy is very different than the Pap, we get concerned that one of them is wrong. Is is the Pap, or the biopsy? We don't want to miss a precancerous lesion of the cervix, so we take a larger biospy. I don't want to minimize the LEEP procedure, but to be very honest, I have done countless LEEP procedures and have never had a patient have a serious complication. As long as your doctor numbs the cervix (with novocaine), you should be fine. It may give you a cramp, but it should not hurt (yes, I know there are ladies reading this that had painful LEEP procedures, but I'm very sincere when I say that it should not hurt).

It is unusual to suggest a hysterectomy for an abnormal Pap smear. The exception is if the Pap keeps coming back as "one step before cancer" or if it actually comes back as cancer. Otherwise, it is usually not appropriate to suggest hysterectomy. In fact, the LEEP procedure will likely cure your problem!

Finally, an abnormal Pap can develop after many years of normal Pap smears. *That's* why we suggest annual Pap smears. I have had widows who have not had sexual relations in 20 years develop precancer of the cervix. The bottom line is that we want to fix this before it becomes cancer. A LEEP procedure is an office-based procedure where you can go back to work moments after it is finished. It will likely cure the problem. I hope things turns out well.

Best wishes,

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

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