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hpv+mild dysplasia

I recently had abnormal pap results and then had a coloscopy and a biopsy.  The results indicated mild dysplasia caused by hpv, specifically flat condyloma in my cervix.  My doctor didn't really explain what this means.  He said that it was up to me whether or not I had surgery to remove the pre-cancerous cells in my cervix.  He also said that both the pre-cancerous cells and the hpv should clear up on their own over time.  As of right now, I had decided to wait until my next 6 month checkup and see where things are at.  But, I can't stop thinking about it all and what it means.  Is there a chance that the hpv won't clear up?  Will I always be infected?  Would having the treatment to remove the pre-cancerous cells also treat and remove the flat condyloma?  Or will I have that forever?  He didn't mention any treatment for it, more just suggested it should clear up over time or at the least become dormant.  He did say it could become active during pregnancy/at birth.  I guess I'm wondering if a)  I should have the surgery to remove the pre-cancerous cells or just wait and see if they heal on their own; b)  will I always have hpv? ; c)  Can I give hpv to future partners?  ; d)  If it does clear up on its own, do I have to inform future partners I had hpv?  ; e)  A nurse told me that often having pre-cancerous cells in the cervix can lead to ovarian cancer later...any truth to that?  She also suggested a full hystorectomy would prevent this....true?  I don't want children, I'm 26 and I know I will never want kids, would having a hystorectomy get rid of both the pre-cancerous cells and the hpv infection in my cervix?  Thanks for your help.
4 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
You are asking almost every question there is about HPV infections of the cervix, the relationship to cancer and pre-cancerous changes, treatment, and transmission.  A really proper reply would take me an hour and even then would miss many important points.  I'll answer some of your specific questions briefly, but you really need to do some general reading about HPV.  I'll give some web addresses below.

Some basic facts:  Everybody gets genital HPV; don't feel like you have been singled out.  Of all cervical HPV infections and abnormal paps with "pre-cancerous" changes, fewer than 1% would progress to invasive cancer--i.e., the sort that could be dangerous--even without treatment. With proper management, as your ObG already has told you about, there is essentially zero risk of a serious outcome.  (There are only around 10,000 such cancers in the US every year, and almost all those occur in women who never got pap smears.)

I can't help with advice about how your HPV infection and "pre-cancerous" cells should be managed; that's up to your provider.  But most likely you have a low grade infection that would be unlikely to progress to cancer, even without treatment.  That is suggested by the term "flat condyloma".  Also, if you had a high grade type with likelihood of progression, your doctor would remove the infected area right now.  In other words, the advice that it's OK to wait 6 months probably means you really aren't at much risk, maybe none at all. But that's something to discuss with your own doctor.

HPV just about always goes away, even without treatment. The virus's DNA may persist in tissues for life -- this is a matter of debate among the experts--but even if it does, with rare exceptions the virus cannot be detected, cannot be transmitted to partners, and never reappears in detectable form.  So for practical purposes, people generally are cured by their immune systems, sometimes aided by treatment.  Although you might be able to transmit the infection to a sex partner now, most likely such transmission no longer will be possible after a few months.

The nurse is wrong about ovarian cancer, which is not caused by HPV.  It is an entirely different disease.

Please do the reading I suggested above.  Some excellent sources are the American Social Health Association (www.ashastd.org); my former health department, where I wrote much of the information on HPV myself (www.metrokc.gov/health/apu/std); and the CDC (www.cdc.gov/std).  After you do your "homework", feel free to return here for a couple of (brief) follow-up questions.  You can also get lots of useful information on the MedHelp HPV community forum and STD forum.  

Good luck--  HHH, MD


Avatar universal
Thanks for the information.  I have been reading lots and I guess the only question I still have left is would a total hystorectomy remove both the abnormal cells and hpv infection in my cervix?  
239123 tn?1267647614
MEDICAL PROFESSIONAL
Yes, but it would be gross overkill, like curing a hangnail by amuputating the arm.  No expert would recommend it and no ethical provider would agree to such treatment.
239123 tn?1267647614
MEDICAL PROFESSIONAL
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