Pap Smears

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Pap Smear Testing & Results | Management of Abnormal Pap Smears

Pap Smear Testing & Results

The Pap smear is the best way to evaluate the condition of your cervix.
Annual pap smears can help identify early changes.

Interpreting Your Results:

  • Normal (Negative): Normal cells are seen. There are no signs of cancer or precancer.
  • Atypical Squamous Cells (ASCUS): Abnormal cells are seen; however, they are not considered precancer cells. The abnormal cells may be caused by a variety of factors, including infection, irritation, intercourse, or my be precancerous. Cells are called precancerous when there are changes in them that may, but do not always, become cancer.
  • Squamous Intraepithelial Lesion (SIL): Changes in the cells are seen that may show signs of precancer.
    • Low-grade SIL (LSIL): Early, mild changes are seen in the size of shape of cells.
    • High-grade SIL (HSIL): Moderate or sever cell changes are seen. This suggests an increased risk of “precancer” being present than with LSIL changes.
  • Atypical Glandular Cells (AGUS): Abnormal cell changes were seen that need to be evaluated more closely. Dr. Simmons will meet with you to devise an appropriate treatment plan.
  • Cancer: Abnormal cells were seen that have become cancer. You will need a thorough evaluation and treatment plan.

Human Papillomavirus (HPV)

You may be tested for HPV, which can often be done at the same time as your Pap smear evaluation. HPV is a group of related viruses, a few of which are linked to cervical changes. Genital HPV can be passed from person to person through sexual contact.

Some types of HPV are shown to cause cancer of the cervix. Most women with HPV do not develop precancer of the cervix.

Abnormal Results

Abnormal cells are usually not cancer. Abnormal cells may go through many stages of change before cervical cancer appears which often happens over a number of years.

If the lab finds abnormal cells, Dr. Simmons may suggest more tests. This may be as simple as a repeat pap smear, or possibly a colposcopy or a LEEP. These tests are explained as follows:

Colposcopy

An exam called a colposcopy may be performed. This exam uses an instrument called a colposcope which is like a microscope. It magnifies the cervix to that Dr. Simmons can see changes that may mean abnormal cells are present. A colposcopy is done in the office and often takes less than half an hour.

Dr. Simmons recommends taking 800mg Ibuprofen an hour before the procedure. He also recommends 2 weeks of pelvic rest (i.e. nothing intra-vaginally for 2 weeks, which includes abstaining from sexual intercourse and tampons).

During the colposcopy, if abnormal cells are identified, he may take a cervical biopsy. At this time, he will remove a bit of tissue. It will be sent to a lab for evaluation. Based on the lab results, Dr. Simmons will decide if further treatment is needed.

Loop Electrode Excisional Procedure Procedure (LEEP)

A LEEP is a procedure used when your pap smear indicates the presence of abnormal cells. It serves as a diagnostic and treatment of the abnormal area which is important to prevent the cells from developing into cervical cancer. The excised tissue will be sent to the lab for further evaluation. This ensures that the abnormal area was completely removed and provides a more accurate assessment of the abnormal area.

You may want to take some over-the-counter pain reliever such as Ibuprofen before the procedure.

After the procedure, you may experience:

  • mild pain or discomfort
  • bleeding

If you experience significant discomfort, bleeding that is heavier than a normal period, heavy vaginal discharge, or strong vaginal odor, please call Dr. Simmons. You can expect a black, grainy discharge for up to a couple of weeks This is due to the cauterization.

After the LEEP procedure, Dr. Simmons recommends 2 weeks of pelvic rest. DO NOT:

  • Have sexual intercourse for 2 weeks
  • Lift objects over 10 pounds for 2 weeks
  • Use tampons or douche for 2 weeks
  • Take baths for 2 weeks

Depending on the results of the LEEP, you will need to return to the office for follow-up visits. At the very least, you can expect to return in approximately 4 months for a repeat pap smear to be sure that the abnormal area was completely removed and has not returned.

Cryotherapy

Cryotherapy is a minimally invasive treatment that destroys tumors and other infected tissue with extremely cold temperatures. Doctors use a CT scan or ultrasound to guide liquid nitrogen or argon gas through a cryoprobe to the infected tissue. The tissue cannot survive the cold temperatures and are therefore destroyed and then cleared out by white blood cells.

Cryotherapy is effective in treating pain caused by tumors and nerve diseases. It has shorter treatment and recovery times than surgical procedures. Talk to your doctor if you think you may be a good candidate for cryotherapy.