Colposcopy

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I got my Pap smear test results and they are abnormal, I was told I have High grade squamous intraepithelial lesion encompassing: Moderate dysplasia (CIN 2) whatever that means! I have to have a colposcopy now! Has anyone had one before? I'm scared I have cancer sad

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  • Posted

    Hi Taylor. You are unlikely to have cancer. You have 2nd stage cell changes which are rather common. Colposcopy will serve to confirm the grading (PAP grading is not too reliable) and check for anything more ominous like higher grade changes to evaluate the course of action. The fact that you are being screened properly is good. Yes I recently had a colposcopy for what the pap said were LSIL (low grade changes) but my doctor was not convinced from what he had seen. Luckily. He suggested we do colposcopy instead of waiting for 3 months as suggested by the histopathologist. And we did. It turned out his suspicions were right, my changes were CIN3 (final stage before cancer) and conization was advised. I then had cold knife cervical conization - a conical chunk of my cervix was cut out (and sent for biopsy). Day procedure under light anesthesia. No issues at all. No pain at all. No bleeding no problems. Biopsy confirmed isolated changes, superficial with no cancer. So it was overkill but I prefer that we removed it anyway. I have just gone back for my 6 month evaluation and whatever it was is no longer there. In short, colposcopy itself is nothing to worry about, it is quick and generally painless with a few pinches at the most, totally bearable. Tiny samples of tissue are taken for biopsy to confirm the PAP grading and much more accurate than PAP. Even in the worst case scenario, which is rare and unlikely, that it is something ominous it is typically caught early enough and extremely treatable by simple excision of the affected part. Cervix is not a dangerous place. Any procedures on it are not painful as it has few nerve endings and we screen it regularly so even if you skip 5 years, which most of us don't, you usually discover issues in time before they spread. How old are you and have you delivered any children? Many changes start after birthing due to tears etc. Especially if you are HPV positive or have had HPV. x

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    • Posted

      Thank you so much for your response that makes me feel way less anxious about it! I've read stories where it really hurt and women were in pain for weeks after. I don't have any children but want to in the future so one of my worries was that I wouldn't be able to anymore! My doctor said it shouldn't be a problem smile I'm 24 years old.

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    • Posted

      Ugh...I read horror stories before going in for mine as well. My doctor, a very experienced gyn.oncologist with surprisingly little sense of humor and no bedside manner, just stared at me and said: "pain? bleeding? scar tissue interfering with future pap results? what are you talking about! No pain, no bleeding no scarring! Cervix does none of those things!" However, without having given birth you will likely be a little more tense and sensitive but i would like to stress again that the cervix itself does not have many nerve endings (which comes in handy when baby's head starts to stretch it biggrin. Any discomfort felt will have to do with the skill level of the person performing the punch biopsy at colposcopy. Or your tension. The pinches are (if felt) very very quick (split second) and mild to moderate in intensity (coming from from a person with a very low pain threshold and very high anxiety levels). Some spotting or mild bleeding can occur following the punch biopsy. And after that for a few hours or couple of days some period-like cramping is possible. The first period may start a little earlier and be a little heavier than normal. A tiny bit of burning is possible in the days immediately after the punch sampling. Interestingly my actual surgery was even less eventful than the colposcopy/punch biopsy. Which convinced me that much of any mild discomfort at the latter was mostly related to tension smile

      As for your other concerns, look at it this way: even if your cervix requires surgery in the end (unlikely at your age) you can still carry a baby soon afterwards. At 24 you are so very unlikely to actually have cancer. Most likely you have HPV related lesions with some cell changes that will be either left to sort themselves out or you will be sent for laser intervention or conical excision. I know it is all overwhelming but i know that once you are done you will feel relieved and less afraid. I know so many women who had various grades of changes and some had extensive surgeries for high grade changes and invasive changes and all of them are well, except one person I know who did not go for screens and did not believe doctors she had to have surgery. That didn't work out happily for her sad A friend of mine had 2nd grade changes at 20 and they chose to laser some layers off. She just had her first child now no problem! Full term. The cervix is not that dangerous. We are lucky to be able to screen it and catch any changes really early so even the small risk of cervical cancer is further minimized.

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    • Posted

      CIN3 cervical intraepithelial neoplasia 3rd grade.

      As long as it doesn't state carcinoma in situ anywhere, you have precancerous changes in cell properties and behaviour that are high grade = higher risk. Does it mention your lymph nodes anywhere or just says CIN3? The typical procedure to remove the affected tissue is cold knife cervical conization or LEEP (former is better for CIN 3 because the edges are removed clean and better for the biopsy that will then be performed). It is done under mild general anesthetic (the one that puts you to sleep but not the heavy one where respirator is needed) . It is not painful nor very risky. It is usually therapeutic in the first attempt. Your age is a factor so they may opt to follow the changes and repeat the punch biopsy in 3 months instead of going in for the procedure. If you do end up having conization it should not interfere with your ability to get pregnant quite soon afterwards. Let me know what the doctor decides and how you feel.

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    • Posted

      Mine was also CIN 3. I had conization procedure last September and have just been for a second follow up. It was clear and due for next regular pap after a year. If you are sent for the procedure it is even less uncomfortable than the punch biopsy. It is a day procedure and recovery is swift and normally totally painless. x

       

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    • Posted

      Okay thank you! I guess the CIN3 is results from outside of my cervix but they still need to see what the results from inside are before they make any decisions for treatment. He told me either LEEP, ablation, or I retest with another colposcopy in six months! I am just not a huge fan of anesthesiasad

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    • Posted

      Yes CIN3 is from lesions noted on your colposcopy and is from outer edges or shallow depths. LEEP will remove the surface layers and is typically therapeutic. As far as I know LEEP/ablation is performed under local anesthetic - depending on where you do it. The worst part of it is the smell of burning flesh but should not be painful if done skillfully. Conization (cold knife) is said to be better for CIN3 according to medical papers I have gone through, as you can remove additional surfaces from deeper within the cervix. It may be overkill, but allows for the histopathologist to confirm that the edges removed are clean, limiting chance for oversights and later spread of cell changes. The latter is performed under general mild anesthesia as I said, without respirator = just normal sleep induced by narcotics. No issues waking up, no nausea and other nasty things associated with proper general anesthesia. Both are a day procedure so if you end up asking for cold knife procedure don't worry. If you go with LEEP/ablation - it is straightforward enough. Don't worry too much. I know several people who had ablative procedures at a young age and no future issues - we have all had kids in the meantime and all their paps were clear. If you decide to wait for 6 months, that is fine too. Cervical changes are not usually the galloping kind and it is generally safe to wait it out for 6 months in case the changes withdraw naturally. However I would say there is no need to wait on CIN3 and better to go for the overkill then worry yourself sick for the next 6 months smile The key thing to remember is that you are safe in the sense that you can follow it do something about it and these things usually do not get a chance to escalate nowadays. Hang in there. All this hassle is just caution and not a sign that you are in immediate danger. That's all these paps and colposcopies are for - caution. xxx 

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