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Old 04-21-2011, 05:52 PM   #1
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Abnormal Pap after LEEP

I found out I had HPV in June and a few months later I had a colposcopy where they took a biopsy of my cervix (very painful). It came back moderate to severe cervical dysplasia so I had to have a LEEP procedure on December 1. It went well and they got all the abnormal cells. I have been having pelvic pain since the surgery that comes and goes and I've been to my gyn and family doctor and no one can find any thing wrong.

I had my first pap after the LEEP done in March and I got the results a few days ago. They said my HPV test came back negative but it was abnormal again and I should wait 6 months then get another pap, that it can clear up on its own. What will they do if it doesn't go away, another LEEP? How many LEEPs can I have before it affects my ability to have kids? And how many LEEPs will they do before they try something else and what will they try.

I'm really scared at this point and I feel very alone. Everyone keeps telling me it's going to be ok then it gets worse. It's not ok this whole thing makes me really upset and scared and no one understands because they haven't been through this.

 
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Old 04-29-2011, 09:30 PM   #2
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Re: Abnormal Pap after LEEP

If no one has anything to say could you at least point me to some forums that will be more helpful. I posted twice and have 100's of views but no one has anything to say. I really need some help with this and would like to find people who can relate to what I'm going through.

 
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Old 04-30-2011, 06:20 AM   #3
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Re: Abnormal Pap after LEEP

Quote:
They said my HPV test came back negative but it was abnormal again and I should wait 6 months then get another pap, that it can clear up on its own. What will they do if it doesn't go away, another LEEP? How many LEEPs can I have before it affects my ability to have kids? And how many LEEPs will they do before they try something else and what will they try.
Hi, Kate.
We're not medical professionals here, but I'll try to answer your questions to the best of my knowledge.
The fact that your HPV test came back negative is a great sign. It means your body has cleared the virus that was causing the abnormal cells to develop on your cervix (now you just need to ensure you don't get reinfected, which is very easy to do, because the HPV virus is very common).

You don't say how severe the latest abnormal PAP is, but I'm assuming it's mild, or they wouldn't take a "watch and wait" approach. It's probably just some residual abnormal cells, or it could even be caused by inflammation, a minor infection, or some other (minor) issue. it might not even be related to your previous HPV infection, and therefore not in danger of developing into cancer in the future. If I had to guess, I'll bet it will have cleared up before your next PAP in a few months. The fact is, if you no longer have the HPV virus, then there is nothing to fuel these cells into dangerous, potentially malignant growth. Cervical cancer IS caused by the HPV virus. Period.
If you don't have HPV anymore, then your risk for developing cervical cancer is minimal to nonexistent. If there are still a few stray abnormal cells left in your cervix, your immune system will probably take care of them. Your doctor has ordered a repeat PAP in a few months just to make sure that they clear up.

How many LEEPs will they do, how many will impair your fertility? It varies, it depends. The reason is that not all LEEPs are the same. They take out different amounts of tissue, depending on how severe the CIN is. The more severe it is, the deeper they need to go and the more tissue they need to remove in order to get clean borders.
I've known women who have had several LEEPs and still gone on to have children.
Even if your cervix is severely compromised by LEEP or other surgery, there are still options if you want to have children.
When you get pregnant, the doctor can put a few stitches in your cervix (which is called a circlage), which will help keep your cervix from dilating prematurely and causing miscarriage.
So you see, while cervical surgeries might make pregnancy more complicated, they do not make it impossible. And only in extreme cases, where extensive amounts of tissue have been removed, would such interventions even be necessary. Most women who have one or two LEEPs have no trouble carrying a pregnancy to term, and very few women need more than two LEEPs in their lifetime.

What would the next step be, if the LEEPs fail?
Probably a cold-knife cone biopsy.
A coworker of mine recently had this procedure, after LEEP failed. She was very scared, but she was back at work after a few days and said the procedure was no big deal. She did get clean borders with the cone biopsy, so her CIN was cured.... and it had been very severe: already carcinoma in situ, which is only one step away from invasive cervical cancer.
My aunt also had a cone biopsy about fifteen years ago, and did go on to have another child after that, so I know that the procedure does not necessarily impair your ability to have children (although in my coworker's case, they had to take so much that she told me she probably would not be able to have more children, at least not without medical interventions).

But it doesn't sound to me as if you'll need a cone biopsy, seeing as how your HPV infection is gone. I think your immune system will clean up those few remaining abnormal cells, and you'll need no further treatment. Or if those cells don't clear up on their own, one more LEEP should take care of them, and it will probably be a very minor LEEP, where they only need to take the very top layer of tissue, which would not further compromise your fertility in any way.

Best of luck to you, and congrats on clearing the virus. That really is terrific news. I think you'll see that your troubles will soon be over, now that the virus that caused them is gone.

Last edited by Kali333; 04-30-2011 at 06:30 AM.

 
Old 04-30-2011, 08:12 PM   #4
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Re: Abnormal Pap after LEEP

Thanks so much. My doctor didn't say if it was mild or severe but they didn't tell me the first time either until I had the coloscopy and biopsy. I'm hoping it clears up, I just worry cause I developed the moderate to severe dysplasia pretty quickly. I got HPV from my current bf and within 2 months after us starting to have sex I had the abnormal cells showed on my pap, they said it would probably clear up then in a few months I had moderate to severe and needed a LEEP, I think the paper from the LEEP said it was CIN II. I guess I'm just worrying for no reason. The HPV test did come back negative so hopefully everything will be ok with my next pap.

I've also had some issues since the LEEP. I have pelvic pain that no one has been able to find a cause for and lately sex has be a bit painful and they can't find a cause for that either so that makes me worry too. I'll just have to relax and wait for my next visit, I just hate waiting so long to find out.

 
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Old 05-02-2011, 04:13 PM   #5
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Re: Abnormal Pap after LEEP

If you don't want to wait, you could always just... go to a new doctor, get a new pap smear, and see what they say. You don't have to reveal that you're supposed to be "waiting" six months for your next pap, etc. It's within your rights to get one NOW, if that's what you want.

An abnormal pap will reveal various levels of abnormality.
The mildest level- I believe it's called ASCUS (stands for "something-something cells of unknown significance") is very common, is often not caused by hpv and will not lead to cervical cancer or to a higher level of abnormality, nearly always clears up on its own, and is often caused by a minor infection or inflammation.

You should at least contact your doctor's office and ask whether your latest abnormal pap was an ASCUS pap. If it was, you have little to worry about. it's not significant, and if it weren't for your recent troubles with hpv and CIN, they probably wouldn't even tell you to come back for a repeat in six months; they'd just tell you to come to your next normal appointment in a year.
If your doctor can tell you whether your pap was ASCUS, that should set your mind at ease considerably. An ASCUS pap combined with a negative hpv test is not considered dangerous. It's almost certainly the result of some minor infection that will clear up on its own.

Best of luck.

Last edited by Kali333; 05-02-2011 at 04:14 PM.

 
Old 05-03-2011, 07:55 PM   #6
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Re: Abnormal Pap after LEEP

Youre pelvic pain and painful sex may be related to other problems, i was also suffering from those symptoms and was bleeding way too mych in between periods' i had a biopsy of my uterus that revealed i had chronic endometritis' which is an infection in my uterus, the doctor prescribed me an antibiotic, i am still taking them and in the mean time discovered that i have high risk hpv and cervical dysplasia so dont relly know if the antibiotic has helped yet or not but the doctor said that it should clear up all of the bleeding and pain

 
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