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Re: GYN: HPV Testing From: Efrain Ramirez (eramirez@icepr.com) Fri Mar 24 19:59:05 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: J. Hellriegel: "Re: GYN: HPV Testing" Previous message: Garry Siegel: "GYN: HPV Testing" In reply to: Garry Siegel: "GYN: HPV Testing" Next in thread: J. Hellriegel: "Re: GYN: HPV Testing" Reply: J. Hellriegel: "Re: GYN: HPV Testing" At Fri, 24 Mar 2000, Garry Siegel wrote: > >I have begun to selective test for HPV type in paps or tissue in order >to try and triage follow up better. I am wondering if others have >started doing so, and if so, what are common scenarios for which they >test? I do not do HPV typing -- did for a while years ago (try it)-- not helpful. >Two cases to discuss: > >1. 30 YO who had a cryo years ago, no records, with paps over that last >3 years intermittently ASCUS or reactive. In 1996, I had seen a couple >of areas of unimpresssive white epithelium that were squamous atypia on >biopsy. In 1997, her colpo was normal. > >When she was in for a pap recently, she was tested for HPV and was >postive for a high risk type. The lab screwed up and didn't actually do >the pap, however. So, I am wondering what follow up she needs short of >doing a pap, of course. Assuming that her paps don't worsen. . . > >Paps 2 or 3 times a year, unless worsened than ASCUS/reactive? > >Colpo once or more annually, interspersed with paps? > >Other? Pap and colpo q.-4/12- 6/12 >Tentatively, once I talk to her, I'm likely to have her come in within 4 >to 6 months to do the pap that didn't get run by the lab. > >2. 44 nulliparous YO menopausal woman, menopausal after >surgery/chemo/bone marrow transplant for Breast Cancer, who had a laser >of her cervix for dysplasia in the late 80s, specifics unknown. After >her bone marrow a couple of years ago, she came in this year and had CIS >on her pap, CIS on her biopsy, and a LEEP with CIS/clear margins. Her >cervix was almost flush with the vagina on one side prior to the LEEP, >and now looks "worse." Her LEEP tissue was positive for high risk HPV. > >Normally, she would have frequent paps over the next year or two, and >probably every six months forever. > >Other options: > >Colpos intermittently, realizing that her menopausal vagina and flush >cervix make colposcopy painful for her, and hard for me. > >Hysterectomy > Same as before-- Premarin cream prior pap and colpo > >Garry > >-- >Garry E. Siegel, M.D., F.A.C.O.G. >Roswell, GA >Private Practice > -- "The things you learn after you know everything are the important ones" Next message: J. Hellriegel: "Re: GYN: HPV Testing" Previous message: Garry Siegel: "GYN: HPV Testing" In reply to: Garry Siegel: "GYN: HPV Testing" Next in thread: J. Hellriegel: "Re: GYN: HPV Testing" Reply: J. Hellriegel: "Re: GYN: HPV Testing"

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