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Old 04-16-2010, 06:15 PM   #4
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Re: AGUS/AGC pap results - questions about ECC & endometrial biopsy

Hi Angel4747, I'm sorry you received this diagnosis, yet I'm glad you are finding some helpful information. Zoe and Lily have given some great information. All three of us have had similar situations, yet there are differences, of course.

I was faithful with my paps from 19 to 44 (actually, still am, and I'll be 47 this year). I always had good paps.

At 44, my doctor did my pap and asked if I wanted the HPV/dna test. I said yes. My pap came back fine, the HPV/dna came back positive for high risk HPV. For various reasons, my doctor didn't make me come back for retesting, she sent me on to a gyno.

I had read a lot about the colpo, biopsy, and ECC prior to my appointment.

As the other ladies said, the colpo was pretty non-eventful. My doctor's exam table seemed lower to the ground than the usual stirrups-table. I got into the stirrups, she swabbed the cervix (didn't feel any different from a pap - actually less noticeable - there was no scraping). Up to this point, the exam felt like a regular ol' pap, before the doctor starts scraping. Then, she moved this machine thingy (the colposcope) closer so she could get a closer view. It looked like some sort of goggles for her to get a closer view. I think, but don't remember, if my doctor projected the image onto a TV screen where I could watch. Some doctors project the images, some don't. The only thing I noticed at that point was that it was taking longer than a pap, but not significantly longer - just noticeably.

I didn't have any atypical cells on my outer cervix so I didn't have any samples taken. Yay! She commented on that and said she was going to do the ECC to check the canal. I think she prepared me for the scrape, but I think she still caught me off-guard. I sat bolt-upright and yelled out (7-8 on a 1 to 10 scale - but it only lasted for a few seconds). It wasn't horrifying, just quite surprising. There was some residual discomfort, but it felt like my period cramps. My period cramps rated probably a 3 or 4 on a 1-10 scale. Later in the day my cramps/discomfort was more like a 1-3 off and on. I took the whole day off, but probably didn't need to.

That was the only procedure I had that day: Colpo and ECC.

My ECC came back "atypical glandular epithelial lesions and adenocarcinoma in situ." Two weeks after the Colpo and ECC I went in for a cold knife cone biopsy. I was under a light general anesthesia for that. At that time my doctor did a second ECC, the CKC, a D&C, and a uterine biopsy. Everything came back fine except for the CKC (adenocarcinoma Ia1 with only one lesion less than 1mm across and 1mm deep).

Back to the colpo and ECC, I took 2 or 3 ibuprofen 30 minutes before my appointment. I also tried to keep my mouth open during the colpo (but must have forgotten for the ECC!). I've read that keeping the mouth open helps keep the muscles in the pelvic floor looser. I've read that some doctors tell their patients to cough right at the time the doctor takes the biopsy. This distracts the patient. I wish my doctor had told me to do that!

My ECC was memorable, but not traumatic. It was over quickly enough. The results it gave back were right on target for what was really going on in my cervical canal. Even though the ECC wasn't fun, I'd have done it every 6 months if I had to for the doctors to catch cancer early. I don't think most doctors do an ECC that frequently, though. The ECC was worth the discomfort, considering the important role it played in catching my cancer so early! I recommend ECCs for women who are over 30 and have tested positive for high risk HPV, regardless of their previous pap history! I think it is THAT important!

Now,

When it comes to HPV testing, if you are already diagnosed with glandular atypia, then I don't know the HPV testing is that important. Most doctors don't use the test that identifies actual strains of HPV; that test is too expensive and there aren't a lot of reasons for knowing the actual number. Treatment doesn't change based on the strain number, just on the damage (like glandular or squamous cell atypia). So actually knowing "yes" or "no" for high risk HPV won't change your treatment options.

re: Local anesthestic
I asked my doctor about this before my colpo. She said the pain/discomfort of having a needle injected into the cervix to numb it is usually as painful (or moreso) than the biopsy or ECC. I suspect she is right. She was right about so many other things.


I think that addresses most of your questions. I know how anxious one is before an unknown procedure, but I can honestly say that my worries and fears were worse than the actual events (except for the quick yelping I did from the ECC).

I hope that helps!