ABNORMAL PAP SMEAR
Pap smear or Pap test is conducted as part of a woman's routine health examination, after the age of 21 years. It is not a diagnostic test, but is a screening tool used to detect any abnormal cells in the cervix. The cervix is the lower part of the uterus that opens into the vagina.
Pap smears help in early detection of any serious medical conditions such as cervical cancer.
Abnormal Pap smears may indicate the presence of infection or abnormal cells called dysplasia. An abnormal Pap smear may not necessarily denote cancer. These results highlight the requirement of supplementary testing to identify and confirm an underlying problem.
Causes of abnormal Pap smears
An abnormal pap smear may indicate any of the following:
Dysplasia (abnormal cells that may be precancerous)
Atrophy or vaginal dryness especially after menopause
An infection or an inflammation
Recent sexual activity
HPV (Human Papillomavirus) infection; also called genital warts
Symptoms Associated with Abnormal Pap Results
Usually, abnormal cells do not produce any symptoms. Moreover, even the presence of HPV in an abnormal Pap smear is asymptomatic. Therefore, a regular Pap smear is beneficial in early detection of any abnormalities.
An abnormal Pap smear secondary to a sexually transmitted infection may induce the following symptoms:
Abnormal discharge from the vagina, such as change in the amount, colour, odour or texture
Abnormal sensations such as pain, burning, or itching in the pelvic or genital area during urination or sex
Sores, lumps, blisters, rashes or warts on or around the genitals
Further Tests after Abnormal Pap Results
Following an abnormal Pap smear, the next step is further testing to confirm the cause of the abnormal cells. A repeat Pap smear or test for human papilloma virus (HPV), a major risk factor for cervical cancer, may also be recommended.
Depending on the age of the patient and the type of abnormal cells, Dr Alexander may recommend the following treatment options:
Loop electrosurgical excision procedure (LEEP): In this procedure, a triangular segment of cervical tissue including abnormal cells is removed by specially designed instruments for evaluation.
Cone biopsy, same as above but usually reserved for deeper lesion. Dr Alexander will make the choice usually depending type and location of abnormality.
WHAT IS COLPOSCOPY?
Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to look into the vagina and into the cervix. The colposcope gives an enlarged view of the outer portion of the cervix.
Why would a Colposcopy be necessary?
Colposcopy is done when there are abnormal changes in the cells of the cervix as seen on a Pap test. Further, it may be done to assess problems such as genital warts on the cervix, inflammation of the cervix, benign growths or polyps, pain and bleeding.
How is the Colposcopy procedure done?
During a colposcopy, you will lie on your back with feet raised just as you do when you have a regular pelvic examination. [doctor] uses an instrument called a speculum to hold the walls of the vagina apart. Then the colposcope is placed at the opening of your vagina.
A mild solution may be applied to the vagina and cervix with a cotton swab. This makes abnormal areas to be seen easily. [doctor] will look inside the vagina to locate any problem. If there are any abnormalities, [doctor] may take a small tissue sample called a biopsy.
You may feel a mild pinch or cramp while the biopsy sample is taken. The tissue is then sent to a laboratory for further study.
What to expect after the Colposcopy procedure?
Your gynaecologist will talk to you about any problems detected during colposcopy. If a sample of tissue was taken from your cervix (biopsy), the laboratory results should be ready in 2 to 3 weeks.
Most women feel fine after colposcopy. You may feel a little lightheaded and if you have had a biopsy, you may have some mild bleeding. Talk to your gynaecologist about how to take care of yourself after the procedure and when you need to return for a check-up.
What are the risks of colposcopy?
There may be a risk of infection when you have a colposcopy. Mild pain and cramping during the procedure and mild bleeding afterwards are common. This most often happens when a biopsy is done. If there is heavy bleeding, fever, or severe pain after the procedure, contact your gynaecologist immediately.
Abnormal Pap smear during pregnancy
A Pap smear during pregnancy is very safe. In case of an abnormal Pap smear, a colposcopy can be performed during pregnancy. However, further treatments are delayed until the birth of the baby. Often, the birth process washes away the abnormal cervical cells.