WOMENS-HEALTH Messages for March, 1999: Re: 4 Abnormal Pap Smears & 3 Normal Colposcopies

Re: 4 Abnormal Pap Smears & 3 Normal Colposcopies

From: Kelly Shanahan, MD (anonymous@obgyn.net)
Thu, 18 Mar 1999 19:57:49 -0600 (CST)

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In reply to: Karyn: "4 Abnormal Pap Smears & 3 Normal Colposcopies"

At Thu, 18 Mar 1999, Karyn wrote: >
>Last March (1998) I went for my regular yearly exam at my OBGYN. One
>week later, I received a call from the office telling me that my pap
>smear came back abnormal. They scheduled me for a colposcopy. During
>the colposcopy, the doctor did not see anything that seemed abnormal but
>he took a biopsy of a small spot that he saw. The test from the biopsy
>came back normal. 4 months later I had another pap smear done - again
>the results were abnornal showing moderate displasia. I had another
>coposcopy done - the doctor didn't see anything very abnormal. Again,
>he took a biopsy and the test from the biopsy came back normal. He then
>told me that I could either wait it out or get the LEEP procedure. I
>didn't want to get the LEEP because I didn't understand what he would be
>removing. I schelduled another colposcopy and pap smear for 4 months
>later. During the colposcopy, the doctor said everything looked
>healthy. This time, he did not take a biopsy but he did do a pap smear.
>I just got off the phone with the nurse - the pap smear showed moderate
>displasia again! Should I have the LEEP procedure? What if after the
>LEEP, I still get the same results from my pap smear? Could the pap
>smear be indicating a problem somewhere else? I am so confused.

If there is a significant discrepancy between a pap smear and a colposcopy, a LEEP (or similar procedure) is recommended. Sometimes an abnormality on hte pap is high inside the cervical canal, where it cannot be seen with colposcopy. Sometimes an abnormality is missed during colposcopy. If a pap is persistently abnormal and the colposcopy is normal, a larger sample of the cervix should be obtained. A LEEP is basically a great big biopsy -- the area of the cervix most vulnerable to abnormalities, the transformation zone, is removed with a shallow loop -- this is done in the office, is quick and not very painful. The tissue is then sent to the lab for evaluation. The nice thing about a LEEP is that it is both diagnostic and therapeutic (the abnormal area is removed)

-- M. Kelly Shanahan, MD, FACOG S. Lake Tahoe, CA

Replies are for educational purposes only and do not construe any doctor-patient relationship; they do not take the place of a face-to-face consultation with your own doctor. Sorry, but personal e-mails will not be answered, due to time constraits and the desire to spend as much free time as possible with my husband and baby daughter

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In reply to: Karyn: "4 Abnormal Pap Smears & 3 Normal Colposcopies"

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