I posted this in the women's issues section, but I just found this area and thought it might fit better here.
I've had three abnormal paps within a year and a half. All of them were due to "Atypical Squamous Cells of Undetermined Significance." So, my OBGYN has now recommended a colposcopy. I'm absolutely terrified. I have no tolerance for pain whatsoever....pap tests even hurt a little bit...not to mention my mind is reeling from the possibilities for the results.
I've been tested for high and intermediate risk HPV strains and the results came back negative for all types. My question...since most cervical cancer is caused by HPV...what else could the results of a colposcopy possibly be? Could I still develop cancer? Are there other things that cause repeated abnormal paps?
I don't know much about this, so I'm just trying to figure out what all this could potentially mean. Looking for info online, all I keep finding are specifics on cancer and HPV.
I don't have the procedure for three weeks and then another ten days for results, so any info I can get now would be so helpful.
First of all, a colposcopy doesn't hurt. It causes less discomfort than a PAP.
The doctor will apply a vinegar solution to your cervix, and then examine it under magnification. Any precancerous lesions will turn white when this solution is applied, and the doctor will be able to see them.
Now, if the doctor sees a suspicious area during the colposcopy, he might take a sample of the tissue- punch biopsy, it's called.
I won't lie, it's a bit painful, but it only takes a second. And the doctor won't do a biopsy without telling you first... so, expect NO pain from the colposcopy, and expect quick, slight pain if the doctor tells you he sees something he wants to biopsy.
I'm not sure why the doctor doesn't just give you an HPV test? I know they don't like to do them on women under 35, but it seems warranted in your case.
Your ASCUS pap results could be caused by inflammation or chronic infection, or they could be caused by HPV-related CIN (abnormal cells/ precancerous lesions).
The colposcopy will be your chance to find out.
If it is HPV-related CIN, it's reassuring that it hasn't progressed at all, from one PAP to the next.
Even if it's low-grade CIN, it will likely clear up on its own, but the doctor will take a number of factors into account when deciding whether it's time to treat it; these factors will include your age, how long the CIN has persisted, what level of CIN it is, etc.
Remember, this is nothing unusual; one out of four women receive abnormal PAP results and have to go through- at least- colposcopy and biopsies, at some point in their lives.
It's a very common and routine gynecological procedure, one that many of your female friends and relatives have no doubt undergone. It's just that women don't usually like to talk about it, so nobody realizes how common it is.
Thanks for the reply. I'm still nervous, but it makes me feel a little better. I'm going into this assuming there will be a biopsy or two...at the very least, just to prepare myself.
It's quite likely... they usually seem to feel the need to do at least one, perhaps so that the colposcopy doesn't seem like a colossal waste of everyone's time, lol. Actually, I think they'd just rather be safe than sorry, so even if they don't see anything very suspicious, they'll take a biopsy anyway.
It's for the best, really. Imagine how great you'll feel if you have a biopsy and it comes back negative. or maybe it'll come back showing that you have mild CIN, and don't need any treatment, just continued monitoring.
Knowing is always better than not knowing, especially with this sort of thing. You can't let cancer sneak up on you; you've got to be proactive, and it sounds like you are.
When I spoke with the nurse the other day to schedule my colpsocopy, she said my pap was "the same as last time" which I took to mean ASC-US. She must have just meant abnormal again because they just posted my results on-line and this time my pap is ASC-H.
Now I'm really worried. Whatever it is, it is progressing after all.
They re-ran my HPV and it came back negative a second time so that makes me feel a little better, but I'm still going to be on edge until this is all over and I have some sort of answers. The soonest I could get the colpo is 8/4. In between now and then, I'm going on vacation...not sure how I'm supposed to relax now! lol
ASC-H means abnormal squamus cells with possible HSIL (high-grade lesions).
Yeah, they'll definitely want to do a colposcopy now.
I would push for one as soon as possible- push for biopsies, whether or not they see anything abnormal, and possibly even push for a LEEP procedure or a cone biopsy (which is diagnostic as well as therapeutic- curative, in most cases).
It is your health, and it is ultimately your responsibility to get to the bottom of this, to find out what's going on.
I can promise you that no little outpatient procedure could possibly be worse than doing nothing and waiting month after month for PAP results that keep coming back abnormal. That will drive you bananas after awhile.
Better to be proactive.
Its been a while since my original post, but I thought I would follow up. I had my colpo today...finally.
Three biopsies were taken (ouch.) One from an area that the doc said definitely looked abnormal. She seemed surprised when I told her I've always tested negative for HPV, which worries me about what exactly she was seeing. She also took two biopsies from a larger area that looked abnormal, but she said that area didn't look as bad and it could be a benign change.
I was a nervous, jumpy wreck and practically in tears through the whole procedure. I have absolutely no tolerance for pain. I have anxiety issues as well. I have a prescription for xanax and I took one of those 30 minutes before the procedure. That usually helps me mellow but I still couldn't stop shaking the whole time.
My nerves were so bad the doc even said if we have to move forward and shave any part of the cervical area, she's going to have me anesthetized. I don't like the idea of being put under, but she's right, I couldn't handle that awake.
So, I'm in waiting mode again and considering the doctor's remarks, I'm already bracing myself for that next step.