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gabbie83 05-11-2011 08:26 PM

newbie: HGSIL & LEEP questions.....
hi everyone
my name is gabbie and im 27 years old
i first found out i had hpv 4/2008 and at the same time my pap came back abnormal for the first time, 9/08 had a colpo/biopsy with lowgrade changes. I was monitored with paps every 4 months, i got pregnant and after my pregnancy i had another colpo/biopsy 10/2009, which was lowgarde also and followed by cyrosurgery (freezing) in 1/10, had two or three paps after that that came back perfect. and 1/11 i had another pap that came back abnormal, thought it would be the same (colpo followed by cyrosurgery) instead after having my colpo in april, my obgyn called and said he wants me to see a specialist, that even though its not cancer he wants someone else to take a look at it ; so he sent me to a gyn onco which i visited yesterday and he recommended the LEEP procedure for me. He said its not a matter of days or even weeks but months that this has to be done. so does this mean that this could change to cancer in a couple of months?
I have a second opinion scheduled with another gyn onco for next tuesday so i wonder what he will say; he will probably recommend the same thing.
my results from my last colpo/biopsy in april came back as:
squamous epithelium showing high grade squamous intraepitheliel lesion (HGSIL) on the cervix &
detached fragments of squamous epithelium with at least low grade squamous intraepithelial lesion in the endocervix curettings

here are my questions/concerns
- does the LEEP (or cone biopsy) ALWAYS have to be performed when HGSIL is found?
- is the LEEP procedure really bad? Were you under completely? This doc said they would give me a sedative which would make me sleepy and then they numb my cervix
- what was your experience with getting pregnant and staying pregnant after the LEEP, how long did you have to wait? (hubby and i had to stop trying for baby #2 once i got the bad news) just wondering what is in the future for us after the LEEP - this gyn onco didnt really want to go into details about pregnancy after LEEP, he said that my OB would answer my questions (i have a call into him) Were you considered high risk automatically after a LEEP?
- what are the chances that what I have now is cancer, and i will find out after the LEEP? I'm really not letting the thought enter my mind BUT i did read that ladies went into the LEEP with HGSIL and found out afterwards that its cancer.

If anyone has any advice or personal experiences please reply to my post

run2642 05-12-2011 03:33 PM

Re: newbie: HGSIL & LEEP questions.....
Hi Gabbie,

I've been through a very similar situation as you, with the exception of having been pregnant. I'm 25 years old and in August of 2009 had an abnormal pap. I subsequently had a colposcopy/biopsy and it showed HGSIL on my cervix and LGSIL in the endovcervix curretings. I was told I had to have a LEEP sooner rather than later as the HGSIL are high-risk for turning into cancer, and my LEEP was scheduled for October. I honestly don't know if a LEEP always has to be done for HGSIL, but my doctor seemed pretty steadfast that I needed one.

From what I've read, it seems like people have a wide variety of experiences with the LEEP, both in terms of how the doctors handle anesthesia/preparation for the procedure and in terms of the pain or discomfort they experienced. I'm sorry to tell you that I had an atrocious experience with the LEEP and cried the whole time from how painful and violative I found it to be. I specifically requested a prescription for an oral sedative ahead of time because I know I get anxious during medical procedures, and my doctor denied me. If you're anxious, you might want to see if your doctor would write you a prescription for one. I was not given any sedative whatsoever and was completely awake and alert for the procedure. I've read it is not uncommon for women to be given twilight or general anesthesia so that they are not awake during the procedure, so this might be an option in addition to the sedative. I would recommend one or the other. The shots to numb the cervix are very painful and the medication in them causes your heart to race, intensifying your anxiety. In my instance, I could still feel burning from the device despite the cervical numbing. The speculum they used was massive, and I don't know if it was due to my body size or fact that I haven't had children but it was extremely uncomfortable. The procedure lasted for what felt like forever, though I would imagine it was 20-30 minutes.

I was told after my LEEP that my lesion had clear margins (a good thing), and my first two follow-up paps came back normal. Unfortunately, I had a pap come back abnormal this week and it looks like I'll have to have another LEEP. I refuse to have another one without anesthesia. I would imagine that if you actually had cancer, this would have been revealed in your biopsy during your colposcopy. The purpose of the LEEP is to keep your HGSIL from turning into cancer.

I am not sure about how long you'll have to wait to try to get pregnant again, but I was not allowed to have sex or use tampons for a month after the procedure. I was also told to wait 6 months for my first follow-up pap because that's how long it takes the cervix to heal. During that time I had a large amount of discharge that I was assured was from my cervix healing, so I would imagine you would probably need to wait at least 6 months for your cervix to fully heal in order to get pregnant.
I'm not yet trying to get pregnant but do want to have children in the future. I do worry about the effect of a LEEP on fertility (especially if I'll have to have another) because it seems like there is not a lot of information out there on how LEEP effects fertility. I would discuss this with your doctor as well as whether there are any safer alternatives to treating your HGSIL.

Best of luck with everything, and let me know if you have any more questions about the procedure.

Sunrader 05-12-2011 11:06 PM

Re: newbie: HGSIL & LEEP questions.....
Went in for CIN1 that we'd been watching about a year and a half. I can't answer most of your questions because I'm past childbearing, but I did just have the LEEP a week ago. It was no big deal at all. No sedative at all. I asked the doctor to use a small speculum and I had some ibroprofen about a half hour before. The doctor was very good and experienced, having been doing these for about 15 years. The doctor numbed the cervix which did sting a little, then did the procedure, all within about 20 minutes and I walked home about a half mile after. They warned me about the heart racing stuff but that didn't happen to me. It was somewhat uncomfortable during the procedure but no worse than any other pelvic exam. I've never felt anything again at all since, no pain, no aching, no cramping, no bleeding, nothing. Some leaking of the medicine he put on it, but that's it. The pathology came back showing some CIN2 which they had never been able to see with any paps or colps before so I felt good that I'd done it and not waited anymore.

Added: I honestly can not imagine going through general anesthesia for this! This was a very minor discomfort for under 20 minutes. No way would I want the expense, risk, and recovery of anesthesia!

cruciferous 05-17-2011 03:35 PM

Re: newbie: HGSIL & LEEP questions.....
I haven't been pregnant but was also diagnosed with HPV in 09' - pap clear. In 10' my pap came back abnormal so I had a colp which showed CIN1. My doctor & I decided to wait. This second colpo showed CINII and a larger transformation zone - so she recommended a cold knife cone. I had a second opinion and the gyn onc agreed with what my original dr. had suggested. I just spoke to her today and she was talking to her friend who is an oncologist & who recommended going the LEEP route with CINII. So looks like I will be having a LEEP soon. My dr. wants to do it at the OR with general anesthesia (fine by me). One of my good friends had a LEEP and said it was fine. I'll come back and repost my experiences with the leep in the next two weeks.

best of luck.

jenbrody 03-22-2012 05:19 PM

Re: newbie: HGSIL & LEEP questions.....
About LEEP and fertility: it doesn't affect fertility at all (the ability to get pregnant). It may possibly weaken the cervix enough that in the later stages of pregnancy it won't stay closed, and if you experienced this problem you'd probably have to get sutures to keep the cervix closed until you reach term. I would imagine that how much tissue is removed is a factor in how likely any of this is to happen. I know that cone biopsies, which remove more tissue, are more likely to lead to a weakened cervix. If you're considering future pregnancies, it should be something to discuss with your doctor before doing the LEEP procedure.

gabbie83 03-26-2012 11:18 AM

Re: newbie: HGSIL & LEEP questions.....
i am actually 33 weeks pregnant ; had my leep in june, got pregnant in august.
i have been monitored for my cervix through out the whole pregnancy. i only had spotting but so far so good:)

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