Advice after LEEP

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I am so sorry this happened to you. Every story a woman tells about how she got HPV-caused dysplasia is sad to me. But stories like yours are the most tragic of all. It's painful enough to know you were betrayed like that by a man you trusted. But that he jeopardized your life makes it even more heartbreaking. Please understand my thoughts are with you.

LEEP's hot wire does leave burn marks on the edges of the margins and can give it a false negative. Hopefully, this is not the case with you. Did you see the lab report from the biopsies taken during the coloposcopy, though? If so, what did the report say? And yes, the medical guides do say cold knife should be done when dysplasia is in endocervical glands, for further diagnosis and to more successfully treat it. If you have any concerns at all, please don't hesitate to get another opinion. That will help put your mind at ease.

Thank you for replying.  The pathology report from my colpo said:

Endocervix: No dysplasia present; sections show pieces of lower uterine segment and secretory endometrium. No squamous epithelium present.  

Cervix: sections show squamous and endocervical mucosa with moderate dysplasia CIN II; HSIL involving endocervical glands. 

But my pathology report for my leep said leep/cone biopsy and severe dysplasia CIN III involving endocervical glands.  It extending close to the margins but was not present at the surgical speciman. 

Does that mean it was worse when they got in there and they had to do a cone instead of a leep?  Would you recommend consulting a gyn/onc because of the glandular involvement?  Do you know anything about the high risk strain 33?

Thanks for sharing all of your knowledge. 

Hi Herenow,

I have CIN III HSIL, high risk strain 33 and endocervical glandular involvement. I read an older posting where you said the size of the biopsies from the LEEP can be telling.  I had 3 and their measurements were:

1.3 x 1.0 x 0.5, 1.3 x 1.0 x 0.5 and the largest was 2.0 x 1.2 x 0.8

I had read that they are usually .8 or 1.0 in a standard leep and the top hat 1cm to 1.5.  Should I be concerned that I had one that was 2.0? 

Thanks

I think you need to get a new doctor. Or at least get a second opinion about all of your lab results to further assess you. This could help put your mind at ease.

One of the contraindicators for LEEP, per the guidebooks I have read, is dysplasia in the endocervical glands. Your doctor removed a lot of your cervix, so hopefully she did get all of it. But I wouldn't trust her, going forward. She should have had a lengthy discussion with you before you signed the paperwork.

If you wonder what your doctor removed, check the physical description of the specimen. To help you, mine was as follows.

Uterine cervix, right, spherical: 2.5x1.4x1.0

Uterine cervix, left, spherical: 2.0x1.0x.9

The most telling was the last, which was described as "endocervical tissue." That was taken from the right side and was also spherical. It was 2.2x1.4x1.1.

Basically, the doctor screwed up and removed the right side of my cervix. In my case, the loop bent when he began the first pass on the right. Rather than remove it, get a new loop, and start from the other direction, he continued hacking away. It sports quite a landing airstrip, now.

Before I forget. Usually, the measurement is from top to bottom x left to right x depth.

My apologies, but I reversed the order of right and left measurements. The endocervical tissue, though, was correct. It was from the right side.