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Inflammatory PapFrom: Robert J Woolley (wooll005@tc.umn.edu)Fri Oct 31 13:59:52 1997
Case for your collective wisdom: 28 year-old medical student, completely asymptomatic throughout the events below, married and monogamous now (though I didn't ask about previous # of partners). Assume her to be reliable for whatever follow-up you recommend. 5/95: Routine Pap, normal. 4/96: Pap with reading "atypical benign (020); Bethesda system--benign pathology", with comment "Inflammation." No treatment instituted. Advised follow-up in 6 months to repeat. 12/96: Pap with precisely the same reading as before. QUESTION #1: Would you recommend, at this point: A) Colposcopy B) Empiric treatment of some sort C) Repeat Pap in 1 year D) Repeat Pap sooner (e.g., 4-6 months) ? I chose D. Which gets us to: 4/97: Normal Pap. QUESTION #2: Would you now continue more frequent Paps, revert to annual schedule, or do something else? (Disclaimer: My medical director is disagreeing with my recommendation after the second "inflammation" pap--thinks colposcopy should have been done then. I obviously disagree, but I doubt that either of us can point to any hard data to support our positions.)
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