One of the most frightening times in a woman's life is when the gynecologist calls and says that her Pap smear results are abnormal. Although you might think an abnormal Pap smear means that you have cervical cancer, the fact is that the majority of abnormal Pap smears are not caused by cervical cancer. The more likely cause of abnormal Pap smear results is inflammation or a vaginal infection.
Because the Pap smear can only screen for potential problems, not diagnose them, your gynecologist may want to take a closer look at your cervix to determine the cause of your abnormal Pap smear results. He will perform an examination called a colposcopy. Your doctor may order this procedure if you have Pap smear results that:
· indicate cervical dysplasia or cervical cancer
· show evidence of HPV
· show first-time or repeat atypical squamous cells of undetermined significance(ASCUS)
Your gynecologist may also order a colposcopy if your cervix appears abnormal during your pelvic exam and Pap smear, or if you have a history of prenatal DES exposure.
Colposcopy is a simple, 10- to 15-minute procedure that is painless and performed in a gynecologist's office. You are positioned on the examination table like you are for a Pap smear, and an acetic acid (such as common table vinegar) is placed on the cervix.
Your physician will use a colposcope -- a large, electric microscope that is positioned approximately 30 cm from the vagina -- to view your cervix. A bright light on the end of the colposcope lets the gynecologist clearly see the cervix.
The Colposcopy Exam
During the colposcopy, the gynecologist focuses on the areas of the cervix where light does not pass through. Abnormal cervical changes are seen as white areas -- the whiter the area, the worse the cervical dysplasia. Abnormal vascular (blood vessel) changes are also apparent through the colposcope. Typically, the worse that the vascular changes are, the worse the dysplasia.
If your physician can view the entire abnormal area through the colposcope, a tissue sample or biopsy is taken from the whitest abnormal areas and sent to the lab for further evaluation.
If you experience any pain during the procedure, it is not from the colposcopy itself -- it's the result of other procedures sometimes performed during colposcopy. These other procedures may cause discomfort, vaginal bleeding or discharge. These procedures include:
The LEEP procedure takes about 20-30 minutes and is usually performed in your physician's office. In some ways it may seem much like a normal pelvic exam because you will lie on the exam table with your feet in the stirrups. A colposcope will be used to guide your doctor to the abnormal area. Unlike a normal colposcopy, a tube will be attached to the speculum to remove the small amount of smoke caused by the procedure.
An electrosurgical dispersive pad will be placed on your thigh. The pad is a gel-covered adhesive electrode which provides a safe return path for the electrosurgical current. A single-use, disposable loop electrode will be attached to the generator hand piece by your physician. Your cervix will be prepared with acetic acid and iodine solutions that enable your physician to more easily see the extent of the abnormal area. Next a local anesthetic will be injected into the cervix; the electro loop will be generated and the wire loop will pass through the surface of your cervix.
After the lesion is removed your physician will use a ball electrode to stop any bleeding that occurs; he may also use a topical solution to prevent further bleeding. You can leave your physician's office soon after the procedure.
After the LEEP you should not:
· Have sexual intercourse for as long as recommended by your physician
· Lift heavy objects
· Use tampons
· Take tub baths--take showers only to prevent infection
It's important for you to remember that having cervical dysplasia does not mean that you have cervical cancer. However, treatment of the abnormal area is imperative to prevent abnormal cervical cells from developing into cervical cancer
Definition: A procedure that involves the removal of a triangle of cervical tissue which contains abnormal cervical cells. Cone Biopsy may be performed in a clinician's office during colposcopy or as an outpatient hospital procedure. Slight bleeding and watery discharge frequently occur following the cone biopsy.
Cervical cryosurgery or cryotherapy is a gynecological treatment that freezes a section of the cervix. Cryosurgery of the cervix is most often done to destroy abnormal cervical cells that show changes that may lead to cancer. These changes are called precancerous cells. Your gynecologist will probably use the term cervical dysplasia.
Cryosurgery is done only after a colposcopy confirms the presence of abnormal cervical cells. Cyrotherapy is also used for the treatment of cervicitis or inflammation of the cervix. Cryosurgery is not a treatment for cervical cancer.
Please see your doctor for advice