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PAP Smear Showed Cervical Ectropion, Bleeding And Discharge. History Of Dysplasia. Cervical Cancer?

Posted on Sun, 26 Aug 2012

Question: Hi doctor, I had an abnormal pap 13 years ago which was dysplasia and have had a LEEP and negative annual paps since then. I had two live births since then, one miscarriage and on abortion. I recently had an episode of post coital bleeding. I had a negative pap two months ago. Just went to my obgyn and under examination he said I had cervical ectropion and took another pap to make sure. He did show me I bled during the pap.he also said he noticed a discharge and swabbed for infection. He is treating me with an XXXXXXX vaginal antibiotic and an oral medicine for yeast. He is also sending me for a pelvic ultrasound. I was stunned shocked and didn't ask if this is serious? Could this be cervical cancer even though I have had many years of annual normal paps? And why didn't he notice the ectropion two months ago? Can it just appear? I'm so confused and worried.

Answered by Dr. Aparna Kohli (4 hours later)

Hi,
Thanks for writing in.
Cervical ectropion is simply a condition when the lining of the inner cervix migrates outside. This lining changes to a form where the cervical cancer usually originates. That is why its important to do a Pap smear. This is known to cause post coital bleeding, vaginal discharge and bleeding on contact.Also since infections are very common, your obgyn has given you a course of antibiotics.
Whether this is serious or not can only be known after the pap results. The risk of cervical cancer is low after a negative Pap.
Cervical ectropion is something found in all women. We dont usually mention it till it causes some problems.
I dont think you need to be worried right now. I am sure you'll be much better after the antibiotics become effective and we have the Pap results out.
Hope that helps.
Let me know if you have any more concerns.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aparna Kohli (20 minutes later)

Thank you so much for your response. It was very helpful. I do have a couple more questions. I am trying to remain calm. I guess I am wondering how much I should worry since I had a pap test like 2-3 month before that was normal and then the year before and 13 years prior were all normal. Even though my pap was like two months ago he did another to be on the safe side. Could it just jump to cervical cancer that fast? I was under the impression that cervical dysplasia is usually seen first and cervical cancer is slow growing. Can my ob/gyn visually see the ectropion and diagnose it during exam? I'm not sure how this popped up all of a sudden. Can having ectropion affect the accuracy of a pap test in the future?
Thank you

Answered by Dr. Aparna Kohli (2 hours later)

Hi
Thanks for writing back.
No, it wouldn't have progressed to cervical cancer that fast. You're right about the dysplasia preceding the invasive cervical cancer. The ectropion can be seen on an exam and in fact this is the place from where we usually take the Pap smear. Everybody has an ectropion. And since this is the place where we take a Pap, this should not affect your Pap result. The ectropion didnt pop up suddenly, it was there all along. Its just that it got infected now. However, I think in your case your obsgyn picked up an infection and sometimes an infection can interfere with the results ( by causing a false positive during a Pap smear).
In fact, even if somebody has an Abnormal pap, we first treat them for an infection and then repeat the Pap.
Hope that helps
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aparna Kohli (11 hours later)

Thank you very much. This is a great explanation. My last question is can this go away on its own or will I need some type of surgery? Also can this leave me prone to future infections?

Answered by Dr. Aparna Kohli (21 minutes later)

Hi,
Thanks for writing back.
The infection needs to be treated, and will not go away on its own. No surgery is needed however. you are predisposed to developing future infections. Also, having protected intercourse and maintaining great hygiene ( keep the area clean and dry at all times) are some ways to prevent future infections.
I am glad I was able to help.
Please close this discussion if you have no more questions.
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar