Looking for Advice on CIN

I am almost 21 years old and have been going through a draining process for the last 2 and a half years. I started paps with my family dr when I was 18. My first ever pap smear was was abnormal and I had 2 more abnormal paps with that dr before I decided to see an ob/gyn. My ob/gyn put me on a 2 month cycle of pap smears and colpsoscopies. To date, I have had 3 colposcopies and 13 abnormal pap smears.

My ob/gyn never really went over my results with me. She just told me my results were abnormal, but I am young and I will be perfectly fine. When I asked her how long I would be doing this process of paps and colpos, she told me 5-6 years. After seeing this ob/gyn for a year and a half, my parents have requested that I see a new ob/gyn.

I had all my pathology reports sent to me so I can bring them to my new ob/gyn, and they are relatively confusing to me. They all say different things from rare abnormalities, ASCUS, ASCH, perakeratosis to CIN I to CIN II. Some of the reports are marked HIGH RISK at the bottom. The most alarming thing to me is that my colpo results classify my CIN lesions as "human papilloma virus lesions," though my HPV test has come back negative every time. Are these things my dr should have discussed with me?

Should I request that my new ob/gyn be more aggressive in my treatment? I researched the LEEP, but my last ob/gyn told me this procedure was out of the question due to my age. She told me she believed the abnormalities would disappear on their own. However, after almost 3 years, they have shown no signs of going away and I'm just getting tired of this continuous process and I don't think I can do it for 5 or 6 more years. Any advice will be greatly appreciated. Thank you and ((hugs!))

Hi there !

I am sorry to hear about u situation, i know how much stress is involved !

i live in germany and here if the pap result is 3D(easy to moderate dysplasia) the doctor apply the rule wait and watch because usually go away without treatment ...but if is more then one year and the pap smear come the  some grad of dysplasia they will make a surgery !

I suppose in u case they wait because u are hpv negative and u are  young also, from what i understand if the hpv test is negative the dysplasia will not progress, will stay the some or go away !

I suppose the doctors know what they are doing but if u will feel better try to see another doctor also (me i see 3 doctors before i decided where to make the surgery).

I hope somebody with expericence from the forum will answer to u questions !I wish i had some answers for u !

Hugs

I'm sorry you have been addressing this for so long. Your parents were right. It was necessary for you to get a different doctor. From what I have read, though, doctor was right, in that you are young. So per the ACOG, dysplasia has a high chance of regressing in very young women, especially with mild and moderate dysplasia. 

The ACOG's concern was that after studies on cervical incompetence from LEEP, particularly because it's so popular, there is a 7.9% risk of miscarrying. The recommendation was to either watch the patient closely or to recommend something less invasive, such as cryosurgery (or laser). I personally don't have a lot of faith in doctors, anymore. But the ACOG is one regulatory group that seems to want what is best for the patient. It may be that there have been too many lawsuits from women who did not need treatment or had the wrong treatment. Or it may be that there is an alarming number of cerclages being done to prevent preterm delivery. I haven't spoken to the people who did the studies, so I don't know what led to this. But I am giving you the above information so that you can understand some of your ex-doctor's concerns.

However, the doctor should have given you a thorough explanation of what you have had, all along, so that you were educated. She should have also given you a thorough discussion of all of your options so that you could make an informed decision about what you wanted to do. Every case of dysplasia is different; every woman's body is different. That's why there are so many ways to approach it, and that's why whatever a doctor does, it must be customized for that woman.

I'm going to give you some links that will help you understand how to read your lab reports. The links will also explain the different treatment options and different types of dysplasia, so just click on the different tabs to maneuver around the websites. It is important to make sure you are fully educated before you agree to anything - waiting longer to see if it finally regresses or choosing traditional surgery. If you do choose surgery, make sure you do what is best for your condition and not what the doctor likes, especially since there are several tools. Doctors have a bad habit of pushing the "treatment de jour" on patients. Please make sure whatever you choose to do, it is appropriate. I realize how upset and frightened you are. But from personal experience, it is very empowering to be fully educated. It will take away the mystery, which reduces the fear because you will be actively involved in what is best. Please also remember that your doctor must work with you. He or she cannot do things to you.

This is an older link, but it's easy to understand.

http://www.mjbovo.com/Women/DysplasiaRx.htm

This link is to a website of one of the few doctors I have run across who wants his patients to be educated. I wish all doctors would follow his example.

http://www.gynalternatives.com/default.htm

And an explanation of terms.

http://womenshealth.about.com/cs/papsmears/a/papsmearrespt2.

http://www.sh.lsuhsc.edu/fammed/OutpatientManual/PapSmear.ht

Something you will want to when you look at the lab reports, again, is to check to see if there is any dysplasia in the endocervical canal or the endicervical glands. You also need to know how many cervical quadrants are involved and how extensive it is. Where were the biopsies taken? What did each one show? Do the reports show any signs of bacterial or yeast infections?

Please also insist on getting tested for HPV strain you have. Roche has AMPLICOR, which is a new test that will tell you exactly what you have. Insurance companies don't like to pay for it, and the FDA has a cozy relationship with certain pharmaceutical corporations. So, you may have to pay for it yourself. Or your doctor may not have it. Or the doctor may not be able to offer it you unless you ask for it. Or you may have to go to a teaching hospital. But I was tested to see which HPV strain I had, and it made all the difference in the world because I knew how to set up a strategy to protect my health. If you have a more aggressive strain, such as HPV 18, then that will tell you if you should insist on surgery. I had HPV-CP6108. I clearly had the time to set up alternative medicine as Plan A.

If it helps you, please know all of here are putting out good thoughts for you. And please bring somebody with you to help you when you talk to the doctor, in case you feel overwhelmed by what is being said or in case you are afraid you won't remember an answer to a question.