Cervical dysplasia

I had a pap smear done about 2 weeks ago and the results came back that I was positive for HPV with mild dysplasia. I have to go back in for a colposcopy and biopsy. I'm really scared and confused and I have a couple questions:

1. Is there any chance that a biopsy could reveal that the dysplasia is more serious than mild or is the results from the pap smear right?

2. If it is mild dysplasia, will I have to get the LEEP procedure or is that unnecessary for mild dysplasia?

I would really appreciate any help, thanks!

[Elaine Brown, MD]

Hi!
Tons of young women have HPV, and we are realizing that in 75-90% of cases if left alone, they will clear the virus themselves.  The virus is what causes dysplasia, which is a fancy word for abnormal appearing cells. The only real reason to do a colposcopy is to be sure that you don't have worse (high grade) dysplasia, which behaves very differently and can become cancer if neglected. If your biopsies confirm low grade dysplasia there should be no need for a LEEP procedure.  If the doctor wants to do that, you should strongly consider getting a second opinion!  In the event that the biopsies DO show high grade dysplasia, the LEEP procedure is usually my next step for my own patients.

Low grade dysplasia tends to be annoyingly persistant, and can come and go, so you may be in for a lot of PAPs in your life time (until we find a cure).  But the only way you should ever have to worry about cervical cancer is if you don't go and get the paps and colposcopies when they are recommended.

I used to spend 1/2 day per week in the office just taking care of dysplasia--so you are definitely NOT alone!

Good luck!
Dr B