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Pap Smear Showed Changes In Cells And Positive For Virus. Copolscopy To Be Done. Worrisome

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Posted on Tue, 19 Feb 2013
Question: My wife got a letter saying that (1) her pap smear result discovered mild changes in cells and (2) that she tested positive for some sort of virus. She will be called back for a copolscopy. I am terrified, but she seems to handle it ok. I can't shake worries of a worst case scenario!
doctor
Answered by Dr. Dr. Soumen Patra (55 minutes later)
Hello XXXXXXX

Thanks for writing to us. Here, I am trying to explain the whole thing.

According to your history, your wife have got mild abnormal pap smear result with possibly HPV- Human Papilloma Virus positive (most common causative virus).

In this context, next line of investigation is colposcopy to find similarity/difference with pap smear result to decide way of management for this condition.

1) If both findings are satisfactory or similar, then it favors towards Mild Cervical Dysplasia or CIN1 (Cervical Intraepithelial Neoplasia).

2) In case of unsatisfactory/ different findings, it is suspected that lesion is extending into endocervix or microinvasion/ adenocarcinoma in situ.

She may repeat HPV test from well known laboratory to clear doubt from mind.You may take 2nd opinion prior to take part in any procedure but I think that result will be same, without alteration of morphology of cervical tissue.

She may need to undergo cervical Punch Biopsy for histological confirmation of diagnosis. Consult with your oncologist and do the suggestive procedure.

Early diagnosis and treatment is very much helpful in prevention and cure of cervical dysplasia or cancer. So focus on her treatment procedure. Do other investigation like ultrasound scan (USG) for lower abdomen and thyroid profile also.

LEEP is the procedure of choice for treating cervical dysplasia (preferably CIN 2&3) due to ease of use, cost effective, performed under direct colposcopic visualization and provision of tissue histological evaluation.

Your wife's age is 40 yrs with possibly completed family. So she can undergo LEEP procedure. Alternatively Cryotherapy may be done in very early stage or CIN1.

Don't be tensed/ worried. Consult with Oncologist and schedule for the procedure.

She should maintain genital hygiene properly. Wish her better health in future.

Hope I have answered your query. If you have any further questions I will be happy to help. Please accept my answer if you do not have other query.

Regards,
Dr Soumen.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Soumen Patra (26 minutes later)
She was to her Gyn for a routine checkup on another matter, without the colposcope, and when she mentioned the abnormal pap the gyn said: "well the cervix looks undamaged to the naked eye". is this in any way reassuring that it won't be anything dangerous?
doctor
Answered by Dr. Dr. Soumen Patra (19 minutes later)
Hello XXXXXXX

Thanks for follow up query. I am happy to help you.

According to her gynecologist, above finding signifies mild cervical dysplasia or very early stage of CIN as cervix looks well on naked eye. Though, colposopic examination is essential to make decision on way of management. But in this stage, early treatment is very much helpful to cure completely or prevent further cervical changes.

So you do not need to worry much regarding this and focus on next line of investigation/ treatment after consultation with oncologist and gynecologist.

If you do not have any clarifications, you can close the discussion and rate the answer.

I think that it is sufficient for your information. Be well & stay healthy.

Regards,
Dr Soumen.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Soumen Patra (2 minutes later)
ok, thanks. but just to confirm then: do you mean that if cervix looks fine to the naked eye, this means that it can not be anything XXXXXXX or advanced at this point?
doctor
Answered by Dr. Dr. Soumen Patra (13 minutes later)
Hello XXXXXXX

Thanks once again for your query.

On naked eye examination, if cervix looks healthy, then it is mostly not XXXXXXX at this stage but naked eye examination may differ with colposcopic findings.

In that case, she should undergo one of the above said treatment modalities that suits her accordingly after consultation with her treating doctor.

If you do not have any clarifications, you can close the discussion and rate the answer.

Regards,
Dr Soumen
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Soumen Patra

OB & GYN Specialist

Practicing since :2011

Answered : 4058 Questions

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Pap Smear Showed Changes In Cells And Positive For Virus. Copolscopy To Be Done. Worrisome

Hello XXXXXXX

Thanks for writing to us. Here, I am trying to explain the whole thing.

According to your history, your wife have got mild abnormal pap smear result with possibly HPV- Human Papilloma Virus positive (most common causative virus).

In this context, next line of investigation is colposcopy to find similarity/difference with pap smear result to decide way of management for this condition.

1) If both findings are satisfactory or similar, then it favors towards Mild Cervical Dysplasia or CIN1 (Cervical Intraepithelial Neoplasia).

2) In case of unsatisfactory/ different findings, it is suspected that lesion is extending into endocervix or microinvasion/ adenocarcinoma in situ.

She may repeat HPV test from well known laboratory to clear doubt from mind.You may take 2nd opinion prior to take part in any procedure but I think that result will be same, without alteration of morphology of cervical tissue.

She may need to undergo cervical Punch Biopsy for histological confirmation of diagnosis. Consult with your oncologist and do the suggestive procedure.

Early diagnosis and treatment is very much helpful in prevention and cure of cervical dysplasia or cancer. So focus on her treatment procedure. Do other investigation like ultrasound scan (USG) for lower abdomen and thyroid profile also.

LEEP is the procedure of choice for treating cervical dysplasia (preferably CIN 2&3) due to ease of use, cost effective, performed under direct colposcopic visualization and provision of tissue histological evaluation.

Your wife's age is 40 yrs with possibly completed family. So she can undergo LEEP procedure. Alternatively Cryotherapy may be done in very early stage or CIN1.

Don't be tensed/ worried. Consult with Oncologist and schedule for the procedure.

She should maintain genital hygiene properly. Wish her better health in future.

Hope I have answered your query. If you have any further questions I will be happy to help. Please accept my answer if you do not have other query.

Regards,
Dr Soumen.