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Abnormal PAP: I'm scared!

I recieved a call yesterday that my pap smear from two weeks ago showed dysplasia. Now I need to go back for a colposcopy and further testing. I've never had an abnormal pap before but it has been at least three years since I had my last exam. I don't have any of the risk factors- no history of STD's, never smoked, no family hx, blah, blah, blah, but still.... I'm so scared right now. The soonest available appointment was for Janurary 8 so I have to worry through the holidays. I did ask to go on the cancellation list.

As a nurse, I of course asked lots of questions and then went online to do some research about dysplasia. YIKES! I dug up all kinds of terrifying stories about women who ended up with cervical cancer after a dysplasia diagnosis. Hubby blows it off and says not to worry, but how can I not? I'm freaking out here so I hope someone out there will be able to offer some past experience or advice. Thanks

I know how you feel. Just after my first son was born back in 1981 I went for my pap and was told I had a Class III pap smear. I was looked at under their colposcope and it was determined that I would get the cryo surgery. I was pretty worried but the cryo only took a few minutes to do and that was it. I had it all done in the doctors office. It was a strange sensation and I felt like I might pass out but I have had no other abnormal pap smears since then and it has been 24 years since I had all that done. I rarely worry about it. All my doctors know about my abnormal pap. I am not sure how they classify them now but at that time mine was a Class III which is considered cancer in situ.

The colposcopy is painless. So is the cryosurgery and maybe now they have made it even easier to get through. That has been my experience thus far. No history of cervical cancer in my family, although my mom did take DES when she was pregnant with me.

Hope this helps alleviate your fears. I would call your doctor and get more answers if you are that scared. You will be ok.

HeartsOpenWide, RN

Specializes in Ante-Intra-Postpartum, Post Gyne.

I had an abnormal pap once. I got all freaked out. After they repeated the pap and it came back normal I asked them why it could have come back abnormal the first time. They said it probably that when they took the sample they caused me to bleed a little and that set it off. Whatever! I was just glad it was all fine. Don't get yourself too worked up.

Super_RN, BSN, RN

Has 12 years experience.

i had an abnormal pap last year, also showing dysplasia. the colposcopy was painless, the biopsy they did right after hurt. i'm not going to lie...it friggin' hurt. i went on my merry little way and when my results came back i scheduled a leep procedure. the only part that hurt with the leep is the numbing process...a needle in the cervix does not feel good. i had no history of std's or anything else for that matter, but apparently the main (my doc said approximately 98%) cause of abnormal paps showing dysplasia is a form of hpv. when i first heard that, i was totally disgusted. i told him i sure hadn't noticed anything growing down there and hadn't been with anyone who had either (to my knowledge). males are a carrier of it and pass it along very easily, women obtain the virus and it can only show up inside. i am going back in january for my 2nd follow up pap after the leep. i was very angry that it happened to me, but i am not saying that is what is wrong with you. make sure you discuss everything with your doc. mine was wonderful and answered any questions i had. i was especially freaked out due to cervical cancer being prominent in my family. i wish you the best.

:) super

10ACGIRL

Specializes in CNA/ ALF & Hospital. Has 9 years experience.

Honey, you made me think of this past Sunday (12/18/05) when shortly after the dinner hour, I was getting sharp pains coming from my uteros. It felt like someone using a sharp knife and using it in a butter churn (OUCH!). I was very scared and my residents said I didn't look so good. I said that I was going to try and get in with my OBGYN but, the pain has subsided since then. I just had a PAP 3 wks. ago & it came back normal as I will get out.

Thanks for sharing your stories. It really does help to hear from others that have survived after an abnormal pap! If I have a biopsy done with the colopscopy will I still be able to work that evening? I just wish I could get this done sooner than later.

Super_RN, BSN, RN

Has 12 years experience.

Thanks for sharing your stories. It really does help to hear from others that have survived after an abnormal pap! If I have a biopsy done with the colopscopy will I still be able to work that evening? I just wish I could get this done sooner than later.

well, you could work, but I wouldn't. I thought I would be able to work my 12 hour shift, but afterwards...no. I did not end up working. Personally, I thought it was painful. Others may not think so, but it's my personal opinion.

I had a PAP that showed dysplasia once, but on the repeat it showed normal. My doctor told me that sometimes an infection can cause this type of result. Did they do a repeat?

Aneroo, LPN

Specializes in Cath Lab, OR, CPHN/SN, ER.

I've had one as well- I was 19. Cancer was not something a 19year old shoulder have to think about, so I am sure I was just as freaked as you are right now.

I had the colopscopy done. The actual procedure did not hurt, but afterwards I did have menstrual type cramps- they gave me some Aleve in office and it was good. I went shopping afterwards! Everything came back ok with that, and they just did more Pap's that year. Once I had normal paps for a while, I went back to a yearly pap.

My understanding is that it is usually caused by HPV (the same one that causes genital warts). There are a lot of strains of this virus- some cause the warts, some are more likely to cause the cellular changes. I think this is why most woman say "I never noticed anything growing down there".

*hugs* to you- Regardless of what we tell you, it's scary until you find out everything came back normal!

ortess1971

Specializes in OR.

I had a biopsy done with the colposcopy and I went to work afterward-It felt a little uncomfortable but I get painful cramps during the first 2 days of my period so the biopsy to me wasn't really much. My doctor however said that if I need a Leep eventually, he likes to do them in the office. Needless to say that won't be happening-I'm going to insist on him doing it in the OR. I figure, if we get these guys in the OR with vasectomies(which are an office procedure) and they put them under general anesthesia(I'm not kidding) they can do my Leep in the OR. I've seen these cases and me personally, I'd be so afraid,that I'd end up canceling it(I'm a big baby about gynecological procedures:rolleyes: ) There are lots of things they can do for this-I was just like you-SCARED.I think as medical people, we freak out more sometimes. A nurse I work with said to me "I'm sure you already have yourself going through chemo right now" and she was right, I went right to the worst case scenario. I feel better about it now-I have a class one dysplasia and am going back in February to have another pap smear. These things tend to move slowly and there are lots of treatments. Hang in there! PS. I also had no history of STD's and have been with only 2 people and I'm responsible about protection so I was thinking, what the hell???

I had a PAP that showed dysplasia once, but on the repeat it showed normal. My doctor told me that sometimes an infection can cause this type of result. Did they do a repeat?

No, they just scheduled me for a colposcopy. This is what has me thinking it's really bad. Maybe I should call again and pester for more information. I'd actually like to know exactly what the lab report said.

Super_RN, BSN, RN

Has 12 years experience.

No, they just scheduled me for a colposcopy. This is what has me thinking it's really bad. Maybe I should call again and pester for more information. I'd actually like to know exactly what the lab report said.

For the colposcopy the only thing they do is get a "magnifying glass", coat the cervix with some dye, and it will show any abnormal cells more clearly. That part is not uncomfortable. I had scheduled the colposcopy and then a biopsy to be done if the cells were indeed found.

My OBGYN goes straight to colposcopy with an abnormal pap. He doesn't feel that a follow-up pap is as beneficial as being able to see things clearly.

I know this because I asked about it at my recent pap when I found out that approximately 1 in 3 people have been or will be infected with HPV at some point in life!

CseMgr1, ASN, RN

Specializes in Case Management, Home Health, UM. Has 39 years experience.

I think I had maybe one "normal" pap smear during my 36 childbearing years. One of my gynecologists told me years ago that I was born with an abnormal cervix: the glands which help to protect it are supposed to be on the inside and mine wound up somehow on the outside, resulting in chronic cervicitis and abnormal PAP's. I had cryosurgery, but the condition returned after my son was born. Back in 1990, I came back with a Class IV pap, and my gynecolgist went so far as to tell me that I had Carcinoma in Situ and scheduled me for a D&C. Fortunately he was wrong, for the biopsy came back with the same old, same old dysplasia. After I went through menopause, the condition cleared up completely.

AgentR

Specializes in Informatics. Has 8 years experience.

I had an abormal pap. Repeated pap, came back abnormal too. So I went in for the colposcopy and biopsy. The biopsy just felt like a little pinch, I don't think it hurt. I remember thinking after it was over "that was it?!?"

I just had low level changes, and they had me repeat paps every 3 months, until I had two normal ones in a row. It cleared itself up! :)

I've had two colpos, and the pain level depends a lot on the skill of the MD and the sharpness of the instrument (btw, the snips they take for a colpo are teeny, and most docs will only do one or two -- the resident who did my first one took 7). But even the one done by the inexperienced resident I'd only put at a 5 (of 10). And afterwards you can do whatever; I went back to work.

Oh, and both mine turned out to be no big deal.

the only part that hurt with the leep is the numbing process...a needle in the cervix does not feel good.

i'm a pain weenie, if i get a papercut i'm jumping up and down on one foot whining. childbirth would likely kill me or the staff delivering the baby, not sure which.

point being, i had an endometrial bx a few years ago. she numbed my cervix and i didn't feel a thing. i was worried about that part, i thought it was going to hurt and she told me as she was doing it and i didn't feel a thing. maybe it is technique?

scraping the inside of my uterus hurt like crazy and that was awful, but the lido injection i'm thinking must be technique?

zambezi, BSN, RN

Specializes in CCU (Coronary Care); Clinical Research.

Another chat site that I go to has a good motto: Don't waste a good panic...at this point, try not worry too much...my story won't reassure you so I won't share it right now but I will say this:

The colposcopy is not horrible...kind of like a pap but a little different...there is definately a pinching sensation when the biopsies are taken but it is quick...the sound that the biospy device makes was worse sounding than the actual discomfort associated with it...You will probabaly have some funky discharge for a couple of days that is brownish in color (from the acetic acid they put on the cervix), so have some pads or old undies available...I think I had a lift restriction for about 7 days or so, as well as nothing inside the vagina...

If you have to have a cone biopsy it is not bad either, but hopefully your colpo won't show anything to be worried about...

Many women have dysplasia and not many end up with cervical cancer...The majority of cervical dysplasia is caused by the HPV virus...sometimes the virus expresses itself and then can go away...so you may have dysplasia on one exam and then not on the next....If there are abnormal cells, a LEEP or Cone biopsy is usually a "cure"...of course, follow-up is important...

Please please continue to go for your follow-ups, even though you don't have many risk factors...the fact is is that HPV is easily spread- a huge amount of the population has it...most of the time it is not an issue, but it can be, so take care of yourself with the follow-up appointments.

Again, chances are that things will be okay- don't freak out too much yet (I know that waiting is the harderst part!). Ask your doc about taking some ibuprohpen or something before the colpo- I have heard that it helps (though again, I didn't think that it was particularly painful).

I had dysplasia after my son was born, the biopsy hurt just a tad.. but more like a pinch.. its over in a matter of seconds.. very well able to go back to work afterwards-- but i'd take the day off anyways just for some "me" time lol..

I had laser surgery done to get rid of the abnormal cells. I decided i was going to be tough and not have any anesthisia-- you can opt to be put to sleep- but its only a 5 min procedure.. so i felt it was unnecessary- um, it was very painful. They told me most women compare it to be like bad menstrual cramps- but i've never in my life had cramps that bad- even the labor and birthing of my son wasn't that bad! lol.

They showed me videos of it so i would be prepared.

No sex for 2 weeks was all they advised. some spotting.

i ended up having sex when my 2 weeks was almost over... and i ended up getting a major infection. ouch!

Dysplasia is actually pretty common and is usually nothing. As far as HPV, I was involved in the huge study through the UW here in Seattle that was published earlier this year. The study was the creation of a vaccine to prevent HPV, which is usually what leads to cervical cancer. Studies all vary, but as many as 80% of the population becomes infected with HPV. There is no cure for it, it does not generally even get noticed by those who have it, but it increases the risk for developing cervical cancer. Basically, if they can prevent you from getting HPV, they can greatly decrease your risk of developing cervical cancer. Now, the big debate is when to give the vaccine (must be before any sexual activity, since the virus is so prevalant), and how to market it. It will NOT be a required vaccine, but it would be really nice if everyone would get it.

Having HPV is not noticeable. THe most common forms have no actual warts anywhere, just the virus in your system. THey can tell you have it buy testing your blood. There are other forms of HPV where there are actual warts, but those are not the same forms of virus that have the cervical cancer link.

Sorry so rambling. In this study, I got what ended up being a placebo, and had PAPs every 3 months (I was a starving college student, and was paid and got my checkups free and birth control, etc) Anyway, a PAP came back showing ASCUS, which is abnormal small cells of unknown specification, then I had a repeat which showed mild dysplasia, then had a colposcopy and biopsy. Fairly painless, just ended up with some cramping and had to wear a lumpy bumpy bad for a couple hours. Honestly, THAT was the worst part of the whole thing. Those suck!!

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