LEEP results

My daughter, who is only 20, just underwent a LEEP procedure.  The doctor said the margins were clear, EXCEPT in the center (I assume this means around or along the canal.), but the cauterization may have gotten the "bad" cells.  She is to have another pap in 4 months.  I hope for the best ( Does the cauterization usually work?), but am preparing for the worst (What would be the next step?).  She has high risk HPV and the "bad" cells were high grade.  She is young, sweet and bright AND desperately wants a family of her own someday.

[Elaine Brown, MD]

Hi!
Her young age is definitely in her favor.  MOST young women eventually clear HPV on their own, and their immune system keeps it under control.  It will be EXTREMELY important for her to be vigilant with her paps though.  That is the best way to keep her
reproductive organs cancer-free.  Yes, the cautery usually works.  In my experience the most common result is that the follow up pap is normal.  Very often however, the follow up pap is low grade dysplasia.  If so, she should NOT have another LEEP.  If she were my patient, I would continue to follow low grade dysplasia or atypical cells closely with paps and colposcopy, but would try to avoid removing any more of her cervix unless more high grade cells showed up.
I hope this helps!
By the way, they do recommend the HPV vaccine, even to girls who have already been exposed to some of the viruses, it may protect against other strains.
Good luck!
Dr B