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  • LEEP for mild dysplasia?

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    Old 03-23-2005, 02:59 PM   #1
    Donna 2854
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    Angry LEEP for mild dysplasia?

    Hi everyone - I have been reading these posts and find that people here really help each other and I'm hoping someone can have a comment for me.

    I know I have mild dysplasia as well as high risk HPV and I keep going in for pap - colpo - pap - colpo for the last couple of years. It never shows any progression into CIN2 .
    My doctor, however ,wants to do a leep next week to see if he "is missing anything". Anyone ever had a similar thing? I can identify with some of you and have had a couple of questions answered here ....

    I was scheduled for a LEEP 5 years ago but after I was given the local, the machine failed to work... I changed doctors after that but this "mild" dysplasia continues to persist. I have had one round of cryo and then one normal pap and now its back to pap colpo pap....

    I don't want to go through something if it isnt necessary and sometimes I think they do these tests in order to make money!! really , I do . I know thats not really true but when the dysplasia never gets worse, I sometimes wonder why I keep on having to have tests.
    Last week , I had the colpo again and was called today , still mild dysplasia. grrrrrrrrrrr... but the leep is still scheduled for next week ..
    I hope someone can have some answers for me. I am sooo very tired of this just like everyone else here.
    Thanks bunches and hopefully , I can share my experiences with you all too.

    Donna

     
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    Old 03-23-2005, 05:21 PM   #2
    tpagm
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    Re: LEEP for mild dysplasia?

    Hello Donna-
    Well my situation really isn't too similiar but I can tell you what I have been though... it may help. I just had my leep done last week. I had a pap that came back abnormal mild dyplasia months back however, I tested negative for HPV. I then went in for my colpo and that result came back cin I/II....it progressed. My doctor told me that I should definitely get the leep done just to get rid of the section where the cells are since I don't have HPV. With this she said I should never have a problem again....but lets see how true that is. But Maybe if your dr. goes ahead and does the leep on you and removes those cells that are showing mild dyplasia then maybe you won't have to deal with it anymore because it will be gone. And then you can go from there and see what your next pap shows. But since you do have HPV not sure if it will come back mild dyplasia again. I am hoping my dr. is right that it will be gone since I don't have the HPV. I can't even tell you how many paps I have had in the last year and half. GOOD LUCK I hope this info helps a bit.

     
    Old 03-23-2005, 05:51 PM   #3
    phaedrus
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    Re: LEEP for mild dysplasia?

    I have been on this board since Feb and I have noticed that sometimes there is a significance between how we are treated. I guess it is sometimes a dr rpeference thing, but also it seems as though it can depend on how long someone has suffered with dysplasia or whether there is a lesion present or hpv or who knows what. Though it does seem typical that cin 3/ severe dysplasia is what will require a leep (as cin 1 and 2 can regress on their own sometimes), i know of two people on the board who have been scheduled for a hystorectomy at cin 2/ moderate dysplasia, and yet i also have a friend who at stage 1 a cervical cancer was treated with a leep and cone biopsy. What the difference is I don't know. It sounds like your dr is taking this action as you have a pretty stubborn case of cin 1. Go with your gut, if it seems like the wrong course of action to you, see if you can get a second opinion, or maybe tell your dr that you would like to hold off on surgery and maybe try some alternative therapies.
    Anyway, good luck, let us know what happens....

    Last edited by phaedrus; 03-23-2005 at 05:51 PM.

     
    Old 03-23-2005, 06:02 PM   #4
    ElenaK
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    Re: LEEP for mild dysplasia?

    Donna,

    Does your dr take biopsies during the colpos or is he just reading the acetowhite areas through the colposcope? How are your ECC (scraping of the endocervix) results?

     
    Old 03-23-2005, 06:52 PM   #5
    Donna 2854
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    Re: LEEP for mild dysplasia?

    Thanks ya"ll for the replies... I appreciate the quick responses and comments.

    To Elena - yes, each time I have a colpo , he'll look in there and say hmmmm I don't see a thing -even with the vinegar solution. And then he takes a couple of samples to biopsy. The results always come back negative. Even the endocervical area.
    I noticed he spent more time this time getting a good sample within the canal. Still, today they call and say the test is negative. ... but he still wants to do the leep "to make sure he isn't missing anything".

    I'll probably go ahead with the procedure next week just to make sure there are no sneaky cells up there hiding. I guess I assumed a colpo biopsy would detect anything going on but I wonder if there are areas that could be hidden from the colposcope's view?? Perhaps with more tissue being taken with the leep can provide some more information . Hope so . At least I can get rid of abnormal cells.

    I just wonder WHAT he'll leep when he says he sees nothing up there. This sorta bothers me.

    Of course, I plan to keep ya'll posted. The sharing of information here is invaluable . Thanks again !

    Donna

     
    Old 03-23-2005, 07:12 PM   #6
    ElenaK
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    Re: LEEP for mild dysplasia?

    OK... So the mild dysplasia is a Pap result, not a biopsy finding. It could be a chronic inflammation showing up as LSIL in your Pap... My Pap has repeatedly picked up cell changes as low-grade lesions, although there is no CIN there yet. I guess, what concerns your dr is the discrepancy between cytology (Pap) and histology (biopsy). It is an excellent sign that all your biopsies and the ECC have come back negative.

    Some researchers evaluate the predictive value of an LSIL Pap for CIN (or worse) as low as 55%. Go figure... I, too, am puzzled by the fact that he will be excising tissue without actually seeing anything wrong. Maybe he will take a sample from the transformation zone, the area that causes us women so much trouble.

    Hope all turns out well!!!!

    Hugs


    Last edited by ElenaK; 03-23-2005 at 07:18 PM.

     
    Old 03-24-2005, 05:17 AM   #7
    Donna 2854
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    Re: LEEP for mild dysplasia?

    re the transformation zone.... is this area not visible to the colposcope? It felt like the dr took several samples whilst looking . . It seems there would have to be an abnormal area to see.

     
    Old 03-24-2005, 09:11 AM   #8
    ElenaK
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    Re: LEEP for mild dysplasia?

    Quote:
    Originally Posted by Donna 2854
    re the transformation zone.... is this area not visible to the colposcope? It felt like the dr took several samples whilst looking . . It seems there would have to be an abnormal area to see.
    Usually yes, but differs from individual to individual. Age is one factor, having given birth is another.

    Sometimes the TZ is completely visible, either totally exocervical or partially endocervical. Sometimes, however, it is not completely visible.

    A LEEP is a local destructive technique that can be applied for diagnosis if a) both the Pap and the colpo are clear, but the biopsies are positive (not your case with the LSIL Pap); b) there is not considerable discrepancy between the Pap and the bio results (you still have to find out what your bio results are... If they are negative, maybe you should reconsider the LEEP???); c) the colpo was declared satisfactory. (This last is something that your dr knows. Did he biopsy adequate samples from all the right areas? Also, a partial evaluation appears on the biopsy report. I saw it in mine. The pathologist declares if the biopsy samples were adequate.)

    You call the shots. However, if your biopsies come back negative or non-dysplastic, why don't you make an appointment with your dr and discuss your concerns? You wouldn't want to take chances with anything invasive done to your body unless absolutely necessary.

    Please forgive my vehemence. I have stopped drs twice from performing unnecessary procedures on me and I am sensitive about this subject.

    Hope this helps a little.

    Hugs.



    Last edited by ElenaK; 03-24-2005 at 09:12 AM.

     
    Old 03-24-2005, 10:27 AM   #9
    lobo1977
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    Re: LEEP for mild dysplasia?

    I think I remember reading that the leep can done as a 'minor' leep or a more severe one - they can control the amount/area well that they take ,so theoretically they can do a mini leep for a lower abnormality, when cryo isnt working or the recurrence is persistant..........it makes sense! I had cryo and ended up at cin3 a few yrs later so I am not a huge cryo fan if you keep having repeat bad paps ...

     
    Old 03-24-2005, 10:35 AM   #10
    ElenaK
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    Re: LEEP for mild dysplasia?

    Quote:
    Originally Posted by lobo1977
    I think I remember reading that the leep can done as a 'minor' leep or a more severe one - they can control the amount/area well that they take ,so theoretically they can do a mini leep for a lower abnormality, when cryo isnt working or the recurrence is persistant..........it makes sense! I had cryo and ended up at cin3 a few yrs later so I am not a huge cryo fan if you keep having repeat bad paps ...
    Good point, lobo! I wasn't aware of that...

    Do they do these mini leeps if Paps are abnormal but colpos and bios are negative? What would you advise our friend to do if her colpo biopsies come back negative?

    How much trust can we place in the Pap (notorious for its margins of error)? But then again, the colpo could have been less than perfect... I guess all this is academic until she gets her path report.

    Wonderful to "see" you again!

     
    Old 03-24-2005, 11:24 AM   #11
    lobo1977
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    Re: LEEP for mild dysplasia?

    Since she is at CIN1 for a while it looks like, having the most minor leep they can do might just clear it up once and for all....But I dont look as it as necessary or required ---as long as she gets relatively frequent colpos to see if its progressed - paps wouldnt work as the diagnostic test, b/c they seem to 'always' be abnormal. Maybe some people just always have some low but non progressing cells?

    On the other hand, (and I dont know the answer to this) if the CIN1 cells being always present even w/ no progression -- have OTHER bad affects...then the leep would be a good idea rather than just monitoring... maybe ask your dr this?

     
    Old 03-24-2005, 11:32 AM   #12
    ElenaK
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    Re: LEEP for mild dysplasia?

    Yes, I agree. Paps can be quirky, biopsies are diagnostic. And yes, one would not want to leave persistent abnormal cells untreated because you never know. My suggestion would be a) get the path report and b) ask the dr LOTS of questions. I suppose, if the path comes back CIN1, i.e. 100% consistent with LSIL, then the LEEP is a good option.

     
    Old 03-24-2005, 03:02 PM   #13
    Donna 2854
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    Re: LEEP for mild dysplasia?

    Thanks ladies for your comments. Its so very helpful to know others are informed about this and willing to take the time to respond. I am grateful

    The last two posts are especially right along the line of whats going on here. I go every 3 months for paps and then here comes the colpo. Results seem always the same. Abnormal pap (mild - LSIL) but a negative colpo. Wait 3 months and repeat.

    Dr never sees anything through the colposcope but always takes samples which come back negative. I"d say this has gone on for a couple of years and I have had at least 4 colpos. Probably more than that. I always go back when I'm supposed to.

    One comment re the TZ... I have never been pregnant , am into menopause now and am 49. Perhaps my "zone" is obscurred from view ? A question I'll ask the dr about.

    I guess I have been going along with this "watch and wait" and have not pursued it more because its so mild. Still , it is a nagging thing . I guess I hope it "goes away" but I do know I have high risk HPV and it probably will not go away.
    Denial I have it? Yeah, I've said "no way"! But yet it persists . And yes, I need to take vitamins and probably folic acid . I also know I need to cut out the smoking .

    Last week, I looked at the LEEP machine and said , "I'll bet you do alot of those" and he said he did. Its almost like I gave him the idea to perfom the procedure on me.
    Soo, I will go ahead next week with questions and allow him to do what he feels is necessary. I will definitely report back here to let you know what happens .

    Thanks again for taking your time to post on here.
    I hope to be able to do the same for others when I feel I have something to contribute...

    Donna

     
    Old 03-24-2005, 03:13 PM   #14
    ElenaK
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    Re: LEEP for mild dysplasia?

    As we women move into menopause, the TZ (aka SCJ, i.e. squamo-columnar junction) changes in size and location. The cervix may begin to shrink and as a result, the SCJ becomes less visible as it gets pulled into the endocervical canal. Since you get regular ECCs, you can be pretty sure that there is no cellular mischief up there, which is always great news!

    Maybe your Pap is picking up natural changes in your body (e.g. a drop in estrogen levels) as an LSIL. I find it hard to believe that after years of colpos and biopsies, all these exams could be false negative. It is great that you are monitoring this!!!

    Please keep us posted.

    PS Please, please quit smoking... You will be helping your body no end to fight off the high-risk HPV!!!

    Last edited by ElenaK; 03-24-2005 at 03:15 PM.

     
    Old 03-24-2005, 03:29 PM   #15
    Donna 2854
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    Re: LEEP for mild dysplasia?

    Elena, I was embarrassed to even admit I smoke. I probably have other cellular changes going on elsewhere as well . Its an awful addiction to beat. Believe me, I've tried to quit several times and always slip up.

    Thank you for continuing to give your comments. I can tell you're not only informed, but also very intelligent.
    Thanks for the info re the changes in the TZ and menopause. I didn't know that. I always read your posts to others .....

    I'll post more next week after my little visit with my dr.
    Hugs to you and everyone here who contributes. I appreciate it very much!!

    Donna

     
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