WOMENS-HEALTH Messages for April, 2000: Re: Abnormal pap

Re: Abnormal pap

From: anonymous@obgyn.net
Tue, 4 Apr 2000 08:39:17 -0500 (CDT)

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In reply to: Mary: "Abnormal pap"

At Tue, 4 Apr 2000, Mary wrote: >
>I have read with interest all the posts including the archives on AGUS.
>I do have some confusion from reading all of the posts. Recently, I
>received an AGUS pap. I had a hysterscopy, D&C with endo tissue taken,
>a colop. I see that some of the doctors on the forum say a cone biopsy
>must be done initially which I didn't have. Isn't an endocervical
>scraping enough?

Yes, the endocervical scraping is enough. A cone biopsy is overkill.

>
>My reports came back fine. I realize that an AGUS pap must be
>investigated since as the forum has pointed out some of these are
>serious and some are a false alarm. One question I have is how come
>sometimes they are a false alarm, in other words after investigation,
>there isn't anything wrong. Why then did the pap say AGUS?

You have to remember that the pathologist that is reading the slide in a back room somewhere. All that he/she can do is to report what they see, and sometimes what they see is not all that clear. Atypical cells of undetermined signifigance are just that, a mystery that needs to be followed up. The majority of such turn out to be normal.

>
>Also, from the recent posts, I was a little concerned that someone asked
>if the AGUS reoccurs or persists that a hysterectomy would be warranted
>even if her tests come keep coming out fine. This kinda scared me
>because I of course don't know if my AGUS pap will happen again and I
>certainly don't want a hysterectomy. There must be alternatives. What
>would they be if a reoccurance happens or persists?

Hysterectomy is NOT the appropriate treatment of AGUS pap smears, unless some definitive pathology is discovered. Recurrent AGUS paps are very concerning, but given a thorough workup, and no discernable pathology, I am not very likely to move to hyst. You can follow the patient closely without going that far.

--
William D. McIntosh, MD, FACOG
Clarksville, TN

This is for educational purposes only, and is not intended to be replacement
or substitute for consultation and examination by an appropriate medical
professional.  Due to time constraints, private e-mails cannot be answered.

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