Following my annual OBGYN exam, my doctor called me and told me that my pap smear had come back atypical. She said that they needed to perform a colposcopy and biopsy to determine if I had cervical dysplasia possibly related to HPV (my HPV test had come back "equivocal" - not positive, not negative). During the colposcopy she said that she saw two very small areas that looked abnormal, and biopsied both areas.
A few weeks later, she called and informed me that I had moderate dysplasia. I had two options - receive three acid treatments and if they did not work to have a LEEP performed, or to just go ahead and have the LEEP performed. My doctor informed me that acid treatments are usually only used to treat mild dysplasia, but because I was so young (22), she wanted to offer me the option as sometimes a LEEP can weaken your cervix, causing complications during future pregnancies. LEEP was the textbook treatment for moderate dysplasia though, and after talking it over with friends and family, I decided to go ahead and schedule the LEEP. Although I was concerned about my future pregnancies, the possibilty of cancer concerned me much more.
The LEEP surgery was performed three weeks ago, and today I went to my OBGYN for a follow-up visit. She informed me that the pathology report for the portion of my cervix that was removed showed no signs of dysplasia - it was completely normal, healthy tissue.
After I left the office, I became very upset. I had gone through so much emotional stress over the past few months wondering if I was going to develop cancer, not to mention the physical pain and stress that my body has been under for the past three weeks following the surgery, including severe cramps and bleeding.
I called the office back and spoke with both the nurse and doctor. Neither could offer me an adequate explanation for what had happened. My doctor said that she must have completely removed the dysplasia when performing the biopsy, while the nurse hinted that I may not have had dysplasia at all, saying "cervical inflammation can look a lot like dysplasia under a microscope." After doing a little research, I discovered that cervical inflammation can be caused by a bacterial vaginal infection, which I had at the time of my pap smear.
I also discovered that most doctors perform a second or third pap smear before perfoming a colposcopy and biopsy. During both the colposcopy and LEEP, a vinegar solution was applied to my cervix. The solution turns areas with dysplasia white. My doctor said that she had seen two small white areas during the colposcopy. If what she says is true - she must have removed all of the dysplasia during the biopsy - then what areas showed up white during my LEEP? If it was healthy tissue, it would not turn white, so why did she continue to remove it after seeing this?
I am extremely upset about this entire situation. I feel like I have gone through all of this pain and stress for no reason. Although I am relieved to know that I am okay, I feel violated that part of my body was removed for no reason and that I may have future complications when I decide to have children.
Has anyone else had a similar experience, or can offer me any advice? I am very overwhelmed and confused right now and would greatly appreciate any advice or suggestions. Thanks.
A few things to consider..1st. Who is really to blame, the Dr. or the lab pathologist that read your biopsy slides? When she called you back after your pap test and did the colp/biopsies she did that based on what was read at the lab. When she called you back for the LEEP after sending in the biopsy slides, she again did that on what was determined at a pathology lab after receiving your biopsies. One thing you can do is contact the lab and request all pathology reports from this issue. They will have them and will absolutely send you copies. You have every right to obtain them. 2nd. If she was acting on what your pathology reports indicate you need done then you are probably placing the blame at the wrong door by blaming the Dr..One more thing, 3rd. Be very very careful if considering a lawsuit. Drs. are now for the most part, viewing every pt. as a potential lawsuit and they are really starting to rebel against it. There have been stories in the news of drs. even refusing to treat any pts. they know have been involved in a malpractice suit. Some have even refused to treat those pts. family members.. If you consult an attorney and decide to go that route I would do it with as much secrecy as possible...
Did your Doctor ever offer to repeat your pap? How did you feel the Doctor initially treated you? Were you comfortable with her opinion and advice? After one mild dysplasia smear I'm surprised you weren't offered a wait and see approach? Did the Doctor address the risks and complication rate of the LEEP?
My doctor never mentioned repeating the pap smear. She simply said I needed a colposcopy and biopsy. I have seen this doctor since I was 13 (I had severe cramps related to ovarian cysts). Both my mother and my sister also see her, and I have always trusted her advice and opinion until now.
She did offer me an information sheet about LEEP that outlined the risks - bleeding, infection, narrowing of the cervix, incompetent cervix, etc. My fear of cancer far outweighed the fear instilled by any of these risks though. Because 95% of patients receiving LEEP are "cured", I chose to have it done. I was not convinced that the acid treatments would do anything since they were primarily used to treat only mild dysplasia. My doctor had said that there was a good chance I would still need LEEP after the acid treatments, so I figured I would save myself the trouble and stress of going though that.
i can understand why you're so upset. but foctors are not all-knowing - and if your LEEP had come back with severe dysplasia, you'd be very very happy that your doctor recommended the treatment. the best thing to do in the future is if you ever have to do a procedure (hopefully never!), get a second opinion. this way you can feel much more comfortable about your treatment. also, since you've had a long relationship with your doctor, express your concerns and disappointment in her - i bet you will feel better.
please don't upset yourself about pregnancy...you are young and i'm sure you will heal fine. you would have to get several LEEPs before your cervix would be compromised.
i think a malpractice suit would go nowhere. your biopsy said moderate dysplasia & based on that, any doctor would recommend a LEEP.
It is entirely possible (and not uncommon) for the biopsy itself to completely remove all the abnormal cells (this would potentially be indicated on the biopsy results as "clear margins").
Think of the whole pap/colpo/leep thing like this:
PAP SMEAR: a screening (NOT DIAGNOSTIC!) test that gives a snapshot of the cervical state of health
COLPO w/BIOPSY: a DIAGNOSTIC procedure which can, in SOME cases, also be treatment when the biopsy manages to remove ALL abnormal cells. In addition, the act of biopsy can stimulate the immune system which results in your body clearing up other areas of abnormality. The colpo procedure is done to map the number and location of abnormal areas of the cervix and biopsy both seen and unseen (endocervical canal) areas.
LEEP: can be both diagnostic AND TREATMENT.
NONE OF THESE can guarantee you will never have another abnormal pap. In large part because there is no current cure for the HPV viruses (there's oh, 50 or so strains. But only a half dozen are veddy VEDDY nasty), but also because many factors can contribute to a mildly abnormal pap including but not limited to:
recent sex (which is why you should put NOTHING in your vagina within 24 hours of your pap appointment)
age-related (think: peri/menopause) changes
MORAL of the STORY: the fewer sex partners you have in your life time, the less likely you will have an abnormal pap. Cervical cancer, it seems, is a sexually transmitted disease in 9 of 10 cases.
I have contacted my obgyn office and requested copies of all lab and pathology reports. I would like to see what they say for myself. I am also calling on Monday to schedule an appt. with another obgyn. I would like another opinion, and another HPV test. I am beginning to wonder if I even have it at all...
I have calmed down a bit since the last time I was on here, but I am still very confused and upset about the whole ordeal. If the biopsy did remove all of the dysplasia, then why wouldn't it have come back with clear margins?
I am also a bit concerned that my doctor seemed to rush me into having these procedures done. My pap results came back in the beginning of May, I had the colpo/biopsy at the end of May, and the LEEP at the end of June. From what you all have said, it seems like a lot of doctors like to wait and see if your body can fight it off.
Anyway, I appreciate all of the advice and feedback that everyone has given me. I will keep you posted.
I went through basically the same thing last year too.
Pap came back abnormal..... so instead of repeating the pap, they scheduled me for a colposcopy and biopsy right away. And they found nothing.
I go through this kind of thing alot. Most recently, I had a mammogram done. I am very small so they always have difficulty getting a good picture. So I get a letter telling me I have to go back for "additional imaging to complete the evaluation". So I am really annoyed over this.