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Had an atypical pap and scheduled cold knife conization. Recommended D and C surgery. Need advise?

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Practicing since : 2004
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I had an atypical pap (they said was 'High grade'), got referred to a gyn/onc...he scheduled a cold knife conization...afterwards during the follow up they said, "Oh, it turns out they weren't high grade'...Ummm, ok. But gyn/onc said come back in two weeks. I did. He didn't even examine me, just looked at his lap top and said, ok, come back in four months. I did. He examined and said, "well, since your cervix is so scarred over and closed off, I can't see in to get a good pap"...I recommend a D & C in the surgery center...! Excuse me, but if he had just done a D & C in the first place, I wouldn' have all the scar tissue from the cold knife...I can't help being a little skeptical that all this doctor is doing is Covering his ass as well as lining his pockets with expensive (and not risk free) procedures when other less invasive tests would be sufficient. Also, if I do have atypical cells further up, I will eventually have to have a Hysterectomy....another costly procedure...My biggest concern is that my health is not the priority here, but that I am being seen as a cash cow for this doctor...I don't like this feeling...I like and trust my original Gynecologist much better than this gyn/onc that I have been seeing, but she is Covering her ass too, because she is not a specialist...What is your advice?
Posted Mon, 11 Nov 2013 in Cancer
Answered by Dr. Indranil Ghosh 50 minutes later
Brief Answer:
You can take a second gyn onc opinion

Detailed Answer:
thanks for your query.
It appears that the final histopathology was not suggestive of high grade dysplasia or carcinoma in situ. In that event, transformation to malignancy would be rare. But still, we need to follow up with Pap smears regularly. If good pap smears can't be obtained in routine office exam then d & c seems reasonable. I assume that the clinical exam was otherwise normal.
Also I feel that going for conization when Pap smear shows high grade lesion is justified. A negative D & C at that point would not have sufficed. So I don't think you are being made a cash cow here. Again, nobody can advise hysterectomy upfront for only dysplasia, without trying other measures.
However, if you do not feel satisfied with you current doctor, you can take a second opinion, which can reassure you.

Hope I have answered your query. I will be available to answer further followup queries, if any.
Above answer was peer-reviewed by
Follow-up: Had an atypical pap and scheduled cold knife conization. Recommended D and C surgery. Need advise? 13 hours later
Thank you. This does clarify.
Answered by Dr. Indranil Ghosh 7 hours later
Brief Answer:
see below

Detailed Answer:
You are welcome. If you need no other clarifications then please close the query and give feedback.

Above answer was peer-reviewed by
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