Abnormal PAP After LEEP

• By simplynat
• Posted November 12, 2008 at 2:13 pm
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HI awildfire - sorry to hear you are experiencing persistent dysplasia. Have you received a copy of your medical records?
Do you know if the margins were clear in the LEEP. If there is in fact dysplasia still remaining I would assume that neither the cone biopsy or the LEEP provided clear margins. Have you had a colposcopy since your last abnormal pap? Do you know what were the results of the pap were, did they indicate ASCUS or LSIL?
I know it can take the cervix a long time to heal after surgery and I wonder if it is possible that the healing cervix and inflammation from it could have caused an abnormal result. Some doctors don't re-test for 3-6 months following a LEEP or cone biopsy because of that. Do you know if you are currently testing HPV positive?

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• By awildfire
• Posted November 12, 2008 at 2:15 pm
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I was HPV Positive before but when they texted two weeks ago, she said it came back negative so thats great.
I don't have a copy of my medical records. I should!
I haven't had another colposcopy (what I am dreading). The pap was two weeks ago so now I wait until Jan. to find out something else.
The doctor said it could be that my cervix is still healing from the LEEP so I am hoping for that! She didn't say anything about my pap other than it was abnormal. I should have asked but I was just shocked. I thought everything would come back fine.

I just wondered if it was common to have an abnormal pap after a LEEP.

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• By simplynat
• Posted November 12, 2008 at 5:26 pm
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I'm not sure how common or uncommon it is (I'm sure some of the women here would know) but I would think that it isn't that uncommon. With all of the trauma to the cervix during a surgery it can take a long time for it to heal which, as you know can skew the result. My first LEEP without clear margins, my gyn wouldn't retest for 6 months after. Now - I'm not saying that is proper procedure or not but that was his way of doing things.
I would certainly ask for a copy of your medical records, that way you can find out if the LEEP provided clear margins or not which could be a good indictation if the pap results were confirming the possibility of persistent dysplasia or if it was due to something else. (Also finding out exactly what the results of the pap were too could be really helpful fo you right now as well) The fact that you are currently testing HPV negative, is such a great thing. If by chance, the LEEP did not provide clear margins and there is dysplasia remaining there is a better chance for your body to try and rid itself of the abnormal cells now that the HPV is no longer active. I think there was a link posted here at one time about the body being more able to reverse any remaining dyslasia after a LEEP or cone biopsy - which would be more likely without an active HPV infection.
Best wishes to you!

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• By flowershoplady
• Posted November 12, 2008 at 10:51 pm
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awildfire, sorry to hear you're going through all of this. as simplynat posted, you'll want to get more info from your doctors about your tests. for instance, if the abnormal pap is indicating 'ascus', it could simply be because of the inflammation from your still healing cervix. it's definitely good news that the hpv test is showing negative. is the doctor suggesting a repeat pap and hpv test in january? hopefully those will show normal! if not, i would encourage you to see a gynecologic oncologist if you're having persistent or recurring dysplasia. and, hopefully that's not even going to be needed! but, as you know, you'll always need to continue to have your regular paps and follow ups. let us know how you're doing!

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• By bethieboo
• Posted November 13, 2008 at 11:09 am
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I've had a cone biopsy and it too hasn't cleared up my virus. I am carrying a high-risk strand and after 2 more paps I just had another biopsy and am awaiting those results for further treatment. I personally try not to worry but I'm a mother of two young girls and divorced.... I wish I could be optimistic but because I have constant pelvic pain and went from a CIN1 to a CIN3 in 3 months I know something isn't right. Keep up with what the doctor tells you, try not to stress over it too much, never miss an appointment and whatever you do - think positive!!
p.s. I had clean margins on my cone in Feb, flunked my first test in may and another in august.... just remember it's a common problem and one that is fixable for the majority...

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• By ArkansasRNmom
• Posted November 13, 2008 at 9:53 pm
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Hi, sorry to hear about your bad experience with the conization...I am having one in a few days and wondered if you could tell me more about it, why it was so awful, etc...need to get mentally prepared and decide how much time to take off work. I appreciate your help and hope you are feeling better.

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• By awildfire
• Posted November 14, 2008 at 9:57 am
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Thanks so much everyone. I'm calling my doctor today and having her explain to me exactly what the pap showed.

ArkansasRNmom, I didn't have a cone biopsy but a colposcopy. My colposcopy was very painful during and for at least 3 or 4 days after. It was much worse than the LEEP which I didn't really feel at all until the next day.
With both I had this feeling of my insides "moving around" and that made me nauseous. I know that sounds crazy but not sure how else to explain it.
Everyone has a different experience though. I have heard some women say they didn't have much pain with the colposcopy.
I hope your procedure goes well! I would just take a few days off of work and take it easy! :)

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• By newhere
• Posted November 17, 2008 at 4:09 pm
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Awidlfire, what did your doctor say? I am having a similar situation and am going to get a second opinion as my doctor is not giving me any info. I had a cone last March, had a clear pap in Aug and then an abnormal one in Nov. They are not following up for another 6 months since the HPV part was negative for high-risk HPV. I don't get it. I have had problems with this doctor so I am going to change and hopefully will get more reassurance. Good luck to you!

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• By SuxDont_It
• Posted November 18, 2008 at 12:00 am
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So I had my first abnormal pap in May of 2007, going for paps and colposcopy's every 3 months with minor abnormalities until it became moderate this last february. Got the leep procedure at the end of may, which wasn't bad at all b/c of general anestheshia. Went for my post op appointment where I found out what was removed was severe abnormalities but everything looked good. Just got results from my pap in september that I had an abnormal pap again. Going for a colposcopy again in the beginning of december. Very disappointing to have to start from the beginning but at least I've done it all already and know what to expect. It's a very frustrating process b/c it changes everytime you go but at least as long as your going for regular check-ups it's very cureable. Just can be a long and scarey process!

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• By corellin
• Posted November 18, 2008 at 9:38 am
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Hi SuxDont_It -- Given your young age and the high prevalence of active HPV in your age group, it's always possible that the abnormal results from September represent infection with a new strain of HPV or possibly reinfection with the same strain. If your HPV infection hasn't stabilized (meaning, if your body has not developed immunity to the virus, which can take months or years, then it would be theoretically possible to be reinfected with the same strain). Has your doctor tested you for HPV to see if it has cleared? If HPV is gone, then the abnormal might also just be inflammation that could clear up on its own. If the LEEP treatment was successful, the HPV should have cleared (most often within 6 months).

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• By gilleygirl
• Posted December 8, 2008 at 5:31 pm
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I just got my results from 1st pap smear after leep procedure from the end of June 2008. It came back ASCUS with no dysplasia. How frustrating! Oh well, the nurse did say that it could be irritation from sex or wearing of tampons. I hope so! But I will now go back in March for a repeat pap smear. I guess I should be thankful that I don't have any dysplasia as of yet. As long as I am on top of my pap smears and keep getting checkups, I should be okay!

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• By flowershoplady
• Posted December 8, 2008 at 11:48 pm
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gilleygirl, ascus results at this point after the leep isn't unusual. did the doctor do an hpv test? if not, ask to have one done! hpv testing along with pap smears is the best preventive approach!

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• By maria11754
• Posted February 15, 2009 at 2:05 pm
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I was diagnosed in Jan with High risk HPV. I'm all for a hysteroctomy, passed menopause. Have nothing to loose, My doctor prefers the leep procedure. Feels a hysteroctomy is too radical. I feel cancer is to radical. How are you feeling now? maria

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• By awildfire
• Posted February 15, 2009 at 10:05 pm
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I'm happy to report that I'm doing fine now. My last pap came back normal.
I sure hope it stays that way! Thank you all so much for your replies. :)

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