An Abnormal Pap Smear: What Happens Next?

Many women logically experience anxiety after they receive results from their doctor of an abnormal pap smear. The first thing that is important to note is that this doesn’t mean you have cervical cancer. What it means is that your doctor found some abnormal cells on your cervix, and the cause needs to be identified.

Colposcopy Procedure

Your doctor will perform a colposcopy to identify the nature of these abnormal cells. This test can be used to diagnose precancerous changes in the cervical tissue, vaginal tissue or of the vulva.

During this procedure, a speculum is inserted into the vagina. Your doctor will examine your cervix with a colposcope. This is essentially a tool that has a bright light on the end of it. This device allows your doctor to see the cells up close. Your cervix may be swabbed with a vinegar solution.

If your doctor finds an area of cells that are unusual, he or she may then take a biopsy of the area. This means that a small sample of tissue will be removed from your cervix, and subsequently tested in the laboratory.

After Your Colposcopy

If your doctor didn’t take a biopsy sample, the only after-effects that you may experience is spotting or light bleeding. There aren’t any restrictions for you if no tissue was collected from your cervix.

If your doctor performed a biopsy, you may have light bleeding or a dark discharge from the vagina, or vaginal pain that lasts for a few days. The Mayo Clinic advises that you avoid tampons, douching, and vaginal intercourse for a week after your biopsy has been completed.

LEEP Procedure

Your doctor uses the results of your biopsy to determine if the abnormal cells need to be removed from your cervix. If there is an area of concern that can be identified as precancerous, your doctor may then choose to remove the tissue in this area, using what is known as the LEEP procedure.

The LEEP acronym stands for Loop Electrosurgical Excision Procedure. In this procedure, an electric current is passed through a fine wire loop, to cut away a thin layer of the abnormal tissue that your doctor has identified. A local anesthetic is used. This tissue is then taken to a lab for further testing. Having the LEEP procedure allows healthy cervical tissue to grow in place of the abnormal tissue.

After the LEEP Procedure

The Memorial Sloan Ketterling Cancer Center gives the following instructions for self-care after the LEEP procedure:

  • Rest for the remainder of the day after your LEEP procedure
  • Take acetaminophen or ibuprofen for any discomfort you may have
  • Showering is fine, but no baths until your doctor gives the OK
  • For 4 weeks after, no vaginal intercourse, douching or tampons
  • Use sanitary pads for any vaginal discharge. You may experience vaginal bleeding for 1-4 days after the LEEP
  • 10-12 days later, you may notice more vaginal bleeding, as healing is taking place
  • No strenuous activities for one week after the procedure
  • It is normal to have a late or heavy period after the LEEP

Diagnosis

Upon microscopic examination, tissue samples are used to diagnose the seriousness of the situation. Here is how biopsy results are reported according to the American Cancer Society:

  • CIN1 diagnosis: Only a small amount of the tissue looks abnormal, and it is considered to be the least serious form of cervical pre-cancer. It is known as mild dysplasia.
  • CIN2 diagnosis: A larger amount of the tissue looks abnormal and is labeled as moderate dysplasia.
  • CIN3 diagnosis: Most of the tissue looks abnormal. Known as severe dysplasia, it is the most serious pre-cancer.

If your doctor discovers a pre-cancerous situation, he or she will then take the appropriate steps to keep cancer from developing.