Hi all.
i just went back for my 2wk follow up after the LEEP & my dr. told me they didn't get it all.. there's a chance it can go away on its own... THEN in the next breath he tells me good thing i had it done when i did or else i could have had problems... now i have to wait until Nov. for a follow up pap.. i've been freakin out trying to learn all i can about my chances of whatever they left, turning into trouble... my dr. also said that depending on what happens in Nov. i either have to go through it all again (pap, colposcopy, Leep, etc..) or some women opt to have a hysterectomy so they don't have to deal w/ all of that... i'm 33yo, married & have a beautiful 6yo daughter.. hubby & i have decided looong time ago to not have any more children so that's not the big issue.. it's all the other stuff i have read that COULD happen from having a hyster.. any body have any info relating to 'better' procedures than the LEEP? Thanks for listening to my rant! i really didn't know where else to turn for this kinda 'girl talk.'

Is this the first time you've ever had the whole process? If so, maybe go for one more round then at that point if its still an issue, get the hyster. If its been an issure for a while and you are 100000% sure you dont want more kids, Id go for the hyst now. Then the worrying is over :)

2nd week follow up??

Why would they do a 2nd week follow up? The normally do like a 4-month follow up because the cervix is still healing..

during your 2 week follow up did your dr. do a repeat pap? they usually do a repeat pap in 3-4 months. Also if your dr. doesnt think they got it all....they why is she waiting until November for the follow up pap? i'm confused...

((Danii) I am so sorry to hear the doctor doesn't think he got it all. It must have been a shock to hear this, and now I'm sure your world is spinning! I know mine would be! I imagine he can tell this from reviewing the pathology report from your LEEP speciman (meaning he did not get clear margins). Do you have a copy of your report? Something that might help may be knowing where the margins weren't clear at - the ectocervix (the outside) or the endocervix (the inside). I have done alot of reading about this and you will find they will do close follow up initially when margins aren't clear. A repeat pap in three to four months is to my knowledge, standard. Some of the research even says that residual disease may regress or clear up after the procedure, hence the follow up. I am sure if your biopsy had indicated a cancer they would be reviewing you much sooner. What was your initial CIN stage? I am assuming it was a 2 or 3 due to the fact you had a LEEP. My best advice would be to sit down and have a good conversation with your doctor about this. If he can't provide you with reassurance you need to find one who can. It is your body and your life and you can't let the stress of this get to you (I can tell you it is NOT the nicest thing to have your life dictated by the stress of this). Arm yourself with good information and remember that knowledge is power. If you have any questions, please go ahead and ask them.

((hugs))

Karen

I missed that 2 week part - agreed w/ everyone above. they say 3-4 month followup is good. Although I did go in a month after for her to check that it was healing ok and to take a look - maybe thats what she did? And then just saw some parts left, visually?

when i asked about how many times a person can have LEEP done & what are the chances that from now till Nov. (next pap) that i'd have more of a problem.. and again she suggested we just have to 'wait & see..' but she did say i had 'no clear margins'.. i really don't understand that one & i guess i should have kept asking but sometimes dr. makes u feel kinda dumb...

((Danii)) please correct me if I'm wrong, but I'm guessing your two week follow up appointment was to discuss the findings of the pathology report and maybe a visual inspection of your cervix to see how you were healing? I think the others are confused as to how your doctor could know so quickly that some cells were missed. When the LEEP tissue is removed, it is sent to pathology for biopsy. The pathologist can tell by looking at the tissue if all the abnormal cells were removed. If the pathologist sees abnormal cells extending to the outer portions of the tissue, there is a strong possibility that some cells were left behind ("no clear margins"). On the other hand, if the pathologist sees healthy tissue all around the outside edges of the tissue then it is likely all the abnormal cells were removed (clear margins). It is like a bruised apple. When you slice the bruise off, if none is left you got clear margins. If there is still some of the bruise left on the apple, like maybe you didn't slice deep enough, that means you didn't get clear margins. The LEEP will "cauterize" the tissue as it cuts it away and this may be enough to cause the abnormal cells to regress instead of persist. Your immune system also plays a role in the persistance or recurrence of abnormal cells.

I have heard of women having two even three LEEP procedures. There is also the laser procedure, although your doctor might not opt for this procedure if the cells are in the endocervical canal. The cold knife cone (ckc) is similar to the LEEP in that it removes a piece of tissue that can then be biopsied. The ckc uses a scalpel instead of the wire loop. Unfortunately it really is a wait and see game to see if the cells are going to persist or regress. One question you might want to ask your doctor is what grade of cell changes were found at the margins (the pathology report should also tell you this). If they were CIN 1 (mild) or CIN 2 (moderate) this might give you a little more peace of mind than if they are CIN 3.

I cannot stress enough that you need to discuss this with your doctor. I know it is hard because sometimes they act like they don't give a flying fig about us and our feelings. But your doctor OWES it to you to sit down and give you some answers and/or reassurance on this. If you find it hard to ask your questions, write them down (leave room for the answers) and give a copy to the doctor at the beginning of your appointment. Keep a copy for yourself and go through them with her. If she still doesn't give you the answers you need, you may have to spend some time and energy finding a doctor who will. Don't let the unknowns eat you up inside, get as much knowledge as you can.

Sorry to make this so long, but I hope it helps you a little bit. I'll be thinking of you.

Karen

the 2 wk follow up was to see how i was healing after the leep..
no other procedure was performed at that time but in Nov. i am supposed to get another pap & that is when we'll see what happens from there.

i did contact the original dr. who did my orig. pap, colposcopy, etc.. (she's the one who suggested i have the leep done) & she also told me 'right now i suggest we just wait & see.' she did have a copy of the pathology report faxed to her from my primary care dr. who did the procedure..

at the time i had the colposcopy i was told i had 'severe' dysplasia.. they thought i was CIN II.. that's all... i have been reading up on all i can because i too agree that knowledge is power.. especially when my primary dr. was so eager to suggest that i can just opt for a hyster. & 'be done with all of it.' but then again a hyster. isn't a cure all either...

Hello-

Well I also did not have clear margins from my leep procedure done in March. My results were something along the lines of the part removed was burnt under the leep and they could not provide if whether or not they got it all. My doctor said that I should be ok that she got it ALL. So I went back for my pap on July 7th and guess what it is abnormal (found out last week). So i am kinda in your boat in regards to the leep not being successful. Now I am waiting for the doctor to call me back so we can figure out what to do from here. I will most likely have to do the colposcopy and leep again...but we will see. Just hang in there Danii you will get through this....I am trying to stay in good spirits however, it is so frustrating.

good luck

Karen, your postings have been quite helpful, especially to someone like me who has never been through anything like this before... so thank you!
my dr. didn't even show me my patholody report, however, since i'll be seeing my primary care phys. this friday (im taking my daughter in for her 1st grade physical) i'll definately be asking for copies of that report!

i'm guessing when he did check to see how i was healing, he could easily see what was missed.. it was only like a 5min. look, if that.... i really don't know if the 'missed spots' are in/out (?) but i am thinking i should get a 3rd opinion, cause it can't hurt..

thanks for sharing all the info, trust me, i need it! :)

TPAGM - you are in my thoughts.. it IS frustrating to have to wait when you don't know what it is exactly you're waiting for... i hope it all turns out well for EVERYone!

Dani

My surgeron said after my leep / laser it looked like something might be left and the biopsy said 'unclear' - yet 4 months later everything was ok. Sometimes right after surgery it looks worse than it is. I would definitely suggest a laser as opposed to a 2nd leep, if that would work with the type of abnormalities you have (aka not in the center area)

Also, change doctors if they dont explain everything, fully, and give you copies of all reports/labs. Not worth the extra stress from a non informative dr!

hi Lobo,
i went for my pre-op yesterday and i am having the Laser/LEEP combo. i made sure the nurse explained that to me since i was unsure. i'm so nervous though. i keep thinking of how you told me to relax! i'm trying so hard to but i'm scared...:-(

Danii, I'm glad you've found my posts helpful. I think you may get a few more answers once you have the pathology report in front of you. Good for you for going to get it!

Karen

SLJ - did they suggest that combo or did you? I hope surgeons start to use it more, even though the laser machine is relatively new and expensive it really seems to be an ideal combo and VERY effective!

When is the surgery? And believe me, I'm the BIGGESTTT baby, I cry when I get a papercut or stub my toe - no joke - and this was SO NOT A BIG DEAL --- the worst is before when you're worrying -- and just remember I said all this when you're in that stage :) Honestly when I went home, I felt happy like I was 'fixed' (even though I didn't know the results til last week) it was great to have had something done , at the LEAST you're much better than you were beforehand :)
Think of it like a cut - you have to take care of it to heal it, if you leave it alone it will get worse, but in the end it will be as good as new ......

Keep me posted!

the 2 wk follow up was to see how i was healing after the leep..
no other procedure was performed at that time but in Nov. i am supposed to get another pap & that is when we'll see what happens from there.

i did contact the original dr. who did my orig. pap, colposcopy, etc.. (she's the one who suggested i have the leep done) & she also told me 'right now i suggest we just wait & see.' she did have a copy of the pathology report faxed to her from my primary care dr. who did the procedure..

at the time i had the colposcopy i was told i had 'severe' dysplasia.. they thought i was CIN II.. that's all... i have been reading up on all i can because i too agree that knowledge is power.. especially when my primary dr. was so eager to suggest that i can just opt for a hyster. & 'be done with all of it.' but then again a hyster. isn't a cure all either...

Hi Dani, I'm new to this and am so relieved to find so many others going through the confusion like me. I was diagnosed with CIN 2 and had a Leep done , 3 weeks ago, got an infection, and was told that not all cells were removed and I had a significant amount still, and that I had to be monitored very closely.!!!! What does that mean!!?? I am 37 married with 3 kids and like you figure I should have a hyster.. to stop the worrying.
Since then I seem to think about it all the time and need some sort of re assurance as to where do I go from here.

much thanks
agit

Hi lobo,

My doctor suggested the LEEP/Laser treatment. it was fine! you were right. it was over before i knew it. the worst part was the waiting before but i kept thinking of what you told me. that is was no big deal..

did you experience discharge for a while? i'm still having light brown discharge and some cramps. i'm glad this is all over! thanks so much for your support.

Can Anybody Tell Me If You Can Have Sex The Day Before Or Of The Leep Procedure...i Having One Tomorrow Afternoon..and Am Worried If I Maybe Shouldn't Have Sex Tonight. Thanks...need Answerer Asap!

It is recommended not to have sex the day before/of the Colposcopy because it can skew the results and mess things up... so I wouldn't do it for the Leep either. I just read in a couple articles that you definitely need to wait at least the recommended amount of time AFTER the surgery to have sex. If you don't, there is a high risk of pelvic infection if the cervix has not healed. FYI...

Remember, you are messing with your reproductive stuff and it is better to be safe than sorry.

Ya, thas what i read too. Thats not a problem..but I was hoping for one last chabanG, while we prepare for the long haul. LOL..thanks, i guess we will suffer it out.