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STDs (Expert Forum)
normal pap/ -HPV after cervical dysplasia just 3 mos. ago
Answered by
University of Washington
Seattle - WA
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This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
normal pap/ -HPV after cervical dysplasia just 3 mos. ago
by confusedandfedup, Mar 15, 2005 12:00AM
I was diagnosed when I was 35 with high risk HPV in 2000. I got pregnant and had a colposcopy while pregnant that they were very careful about ( didn't remove much tissue) and the results were mild cervical dysplasia ( C1).....I then lost that baby ( miscarriage unrelated) and got pregnant again so my next colpo was also done with a light touch and came back C1 again.
All this time I was getting abnormal paps in the ASCUS category....After my son was born in March 2004 I had another colposcopy. This time I was not pregnant so the doctor really dug in and removed the whole suspicious looking area. The biopsy said C1 dysplasia again. This was in Dec. 2004 ( just 3 months ago).......
WELL due to other issues from the traumatic forceps delivery of my son, I have to have major surgery for pelvic floor prolapse . I mentioned to the surgeon that I have HPV/dysplasia and he told me I should get a hysterectomy too. I called my regular gyno and asked to be re-tested for HPV just in case it has cleared up because I didn't want to get a hysterectomy for nothing. He refused and said that since I just had cervical dysplasia in December, of course I am still HPV positive.
So last week I went to a new gyno. He gave me a Thinprep which came back NORMAL and an HPV test ( hybrid capture) which came back NEGATIVE.
Are false negatives common?
How could I get a normal pap/ -HPV after having cervical dysplasia just three months ago?
Should I cancel the hysterectomy part of surgery?? I'm scheduled for two weeks from now.
All this time I was getting abnormal paps in the ASCUS category....After my son was born in March 2004 I had another colposcopy. This time I was not pregnant so the doctor really dug in and removed the whole suspicious looking area. The biopsy said C1 dysplasia again. This was in Dec. 2004 ( just 3 months ago).......
WELL due to other issues from the traumatic forceps delivery of my son, I have to have major surgery for pelvic floor prolapse . I mentioned to the surgeon that I have HPV/dysplasia and he told me I should get a hysterectomy too. I called my regular gyno and asked to be re-tested for HPV just in case it has cleared up because I didn't want to get a hysterectomy for nothing. He refused and said that since I just had cervical dysplasia in December, of course I am still HPV positive.
So last week I went to a new gyno. He gave me a Thinprep which came back NORMAL and an HPV test ( hybrid capture) which came back NEGATIVE.
Are false negatives common?
How could I get a normal pap/ -HPV after having cervical dysplasia just three months ago?
Should I cancel the hysterectomy part of surgery?? I'm scheduled for two weeks from now.
Doctor's Answer
by H. Hunter Handsfield, M.D., Mar 15, 2005 12:00AM
, Mar 15, 2005 12:00AM
This is not my area of expertise. I am not a gynecologist and am never involved in the decisions about hysterectomy or other surgical treatment for cancer or precanceous cervical lesions.
But I can say that the Digene Hybrid Capture test is not perfect and will miss some HPV infections. The definitive test is a biopsy; all tests based on cerrvical cytology (pap smear) are secondary to the results based on examining excised tissue under the microscope. It is also my belief that few providers would recommend removing the uterus just because of HPV infection, or for mild dysplasia--only for cancer or advanced precancerous disease, such as CIN III.
Is there more to the story? For example, if a woman had both fibroid tumors and a borderline pap, hysterectomy might be reasonable. In any case, you should not have a hysterectomy until and unless the person proposing it has clearly explained the indication for it, and you understand and agree with it.
Bottom line: Have a frank discussion with the doc who is recommending hysterectomy. If in doubt about the wisdom of the procedure, ask for a referral for a second opinion.
Best wishes-- HHH, MD
But I can say that the Digene Hybrid Capture test is not perfect and will miss some HPV infections. The definitive test is a biopsy; all tests based on cerrvical cytology (pap smear) are secondary to the results based on examining excised tissue under the microscope. It is also my belief that few providers would recommend removing the uterus just because of HPV infection, or for mild dysplasia--only for cancer or advanced precancerous disease, such as CIN III.
Is there more to the story? For example, if a woman had both fibroid tumors and a borderline pap, hysterectomy might be reasonable. In any case, you should not have a hysterectomy until and unless the person proposing it has clearly explained the indication for it, and you understand and agree with it.
Bottom line: Have a frank discussion with the doc who is recommending hysterectomy. If in doubt about the wisdom of the procedure, ask for a referral for a second opinion.
Best wishes-- HHH, MD
I am very encouraged by this normal pap and negative HPV test and my doctor beleives that the biopsy I had in December removed the cervical dysplasia and my body's immune system took care of any remaining HPV. I guess I could ask for another biopsy just to be sure, but HPV doesn't seem anymore like a good enough reason to remove my uterus.
If he used for forceps on you and caused pelvic floor prolapse that is his mistake! A MAJOR WARNING SIGN!
HPV is no reason to get a hysterectomy!! I don't want you to regret it. I'm so sorry that the Doctor did this to you. You need to change doctors. Ask them what they think about forceps and episiotomy. If they treat it like it's routine, then get the **** out of there! If you decide that a hysterectomy would be best, don't use that Doctor! You need a second opinion. Go to a doctor that is open to alternatives. They may surprise you! If a Doctor is too left brained and western they are often too aggressive and intervene when unnecessary. 2 weeks isn't long enough to decide on a hysterectomy! Infact, I wouldn't even want your Doctor to do the other part of the surgery! I beg you to consult a holistic doctor on alternatives for your prolapse. (Something that shouldn't even exist, if the damn hospital would allow you to move around and work with gravity when in labor!) And Please please please have another doctor do the surgery! One that is totally opposite! Too much intervention causes problems that need more intervention!
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Take Care
For anyone else who cares: There are lots of different doctors involved.
The Dr. who delivered my baby is no longer my doctor as I'm so pissed about them not letting me have a C-section.
Then there was a new gyno who diagnosed my HPV and would not re-test. The one who gave me the new HPV test is an even different gynecologist.
The doctor who is doing the surgery is a urogynecologist who specializes in surgery for pelvic floor prolapse.
I don't believe in holistic medicine, herbs, whatever. Thanks anyway.
Best wishes, and good luck with your surgery--
HHH, MD