Scarred Cervix/Cone biopsy

• By ktelleria
• Posted November 19, 2008 at 9:09 am
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me1973, Sorry to hear you lost your dr! I am assuming you had radiation treatment?

In 2001 I underwent internal and external radiation and have had difficulties since.

Because my uterus and cervix were left in tact for internal radiation they were badly scarred by the external radiation treatment. For 8 years my paps were painful and many times difficult to get cells. On a few occasions it was necessary to have biopsy done under anesthesia as an outpatient in hospital. This was done because I was having an abnormal amount of bleeding or pain or things just didn't look right to my dr.

Best of luck with new dr. Perhaps they will give you more information than last dr. Don't be afraid to ask lots of questions!

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• By corellin
• Posted November 19, 2008 at 10:13 am
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hi me1973,
Has your doctor given you an HPV test? Given the difficulties of getting a good pap sample, it might be even more important to use an HPV test in conjunction with pap screening to determine if there's any residual disease.

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• By me1973
• Posted November 19, 2008 at 3:02 pm
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I think in life everything happens for a reason and the Dr. I had left with no warning and had to hunt down my medical records all of them I was unable to get.I had no radiation but severe dysplasia caused by HPV.That was why he performed the cone biopsy.Now the new Dr.is so thorough after looking at the labs I did have he was for 10 years not obtaining cells from my cervix.All the while saying my pap was okay.The HPV is dormant and has been.Back to the new Dr. she the first pap unable to get cells saying that the cervix it is so scarred from the biopsy and this time she tried to dialate and says we will see if she was able to obtain any cells.I asked her if she was unable to get them ,Then what do we do.She said come while you are having your period and we will try that.Still pondering the what ifs I asked about that not working then she mentioned the hospital and being put under.Thats where she lost me cause at that point I was freaking out a bit.So if I understand you correctly you have had to go to the hospital for them to obtain cells as well? Is there no way to widen the cervix??? I thank you both for the replys.It does help so much.Thanks!!!!!!!

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• By corellin
• Posted November 19, 2008 at 11:12 pm
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Hi me1973 -- a pap test can't tell you whether HPV is dormant or not. Only an HPV test can specifically test for an active HPV infection. (Because sometimes paps are normal even though HPV is active.)

I'm really sorry about all the trouble the doctor is having getting a good cell sample. I hope the outpatient procedure works, if you decide to try that... General anesthesia is always nice, because you don't feel a thing!

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• By ktelleria
• Posted November 20, 2008 at 11:06 am
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me1973,

In the past I have had the outpatient biopsy done a few times. (I believe 3 or 4) My scarring was due to radiation as I mentioned above. But it appears scarring is scarring. There was no way to access cervix without anesthesia. The pain was unbearable. So the outpatient was the only way to biopsy for me. The proceedure took about 45 minutes at most. I was in and out within 3 hours and able to go home. I rested the remainder of the day and always had this proceedure done on Friday so I could rest. Never had much pain just a little discomfort.

Hopefully your new dr will be able to obtain cells without this proceedure. But it is really not as bad as it sounds. Wishing you well.
Kimberly

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• By Faith2
• Posted November 20, 2008 at 2:25 pm
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Dear Me1973,

I also had stricture of the cervix and as a result was showing negative Paps when most likely, advanced dypslasia was brewing, and ended up showing CIS within 10 mos of a colpo for mild dysplasia, (diagnosis came after a LEEP).

I would not recommend doing nothing for CIS, though that is always an option. CIS is carcinoma in situ (cancer in place) - it has not invaded, therefore, gynecologist-oncologists don't think of it in terms of cancer, but precancer. In some women, it stays the same and doesn't change, in other women it progresses to invasive cancer. No one knows which woman that will happen to.

Have you considered seeing a gynecologist-oncologist? Depending on the involvement, a LEEP or cold knife cone may eradicate any diseased tissue. Also, I read of a procedure that lasers the cervix so that it stays patent and doesn't constrict. You can ask your dr to see what options you have, or from time to time, go in for dilation of the cervix (mine was done under general d/t discomfort of procedure but also at time of LEEP).

I'm not a dr but, I would be leary of trying to get cells during menstruation - not the best way to sample, esp w/CIN 3 diagnosis, already. Again, I would think a LEEP or cold knife cone under general where the dr could dilate the cervix sufficiently and also possibly sample the endometrium would be best at this point. The D&C or an endometrial biopsy would be done to rule out uterine involvement since the accuracy of your Paps are questionable for a long period of time. Paps are for the cervix only, but if there's been any invasion over time, an endometrial biopsy or D&C would show samples of the uterine lining (endometrium) and show what's going on there - or if all's ok. Just a precaution but why not have everything done at once? I would begin by finding a good gyn-onc.

Keep us posted. Keeping you in my thoughts & prayers.

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• By Faith2
• Posted November 20, 2008 at 2:27 pm
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Also Me1973,

Can you find out what lab your previous dr was sending your Paps to? There may be a possiblity of obtaining pathology records that way.

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• By me1973
• Posted November 21, 2008 at 4:10 am
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Thanks Faith2,Yesterday I called the hospital where the biopsy was done and got the release faxed and they still have my pathology reports.Seems they need to hang on to those for 20 years.I am very happy about this because the new Dr.really had wanted to see them.Thank You so much for the inspiration,prayer,and blessings! I send them up for you and all as well!

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• By Faith2
• Posted November 21, 2008 at 10:31 am
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Thank you!

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• By me1973
• Posted November 25, 2008 at 4:14 am
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Just wanted again to say Thanks so much to you beautiful ladies.Well the pap test came back and all is within normal limits.I can now wait until another year to start dwelling on this again.I am so blessed that it needed not to get all involved again.I tell you the cone biopsy was nothing to joke about and the way she has to get in there to get a smear is not either.Like I said Thanks to you all and have a Happy Holiday!!!!!!!!!

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