Abnormal Pap Smears


Pap smears are screening tests.  When we identify abnormal cells by pap smear, we proceed to a more accurate test called colposcopy.  Colposcopy is done by looking at your cervix under a microscope to identify abnormal appearing cells or blood vessel changes of the cervix.  When we see areas of concern, we take small pinch-biopsies of these areas and send the tissue to a pathologist who is able to more accurately evaluate the cellular abnormalities. The procedure is very well tolerated in the office.  You might want to take two ibuprofen tablets 200 mg prior to the procedure, but you would return to routine activity after the procedure.  We do advise pelvic rest, no tampons or intercourse for 5 days after the procedure to avoid infection of the biopsy sites. 

Cryotherapy is a freezing technique using nitrous oxide (liquid nitrogen) to treat persistent abnormal cellular changes of the cervix. The procedure is usually performed in the office and requires no anesthesia.  If your pap smear continues to have mild abnormal changes, we might recommend treating this by freezing the surface abnormal cells of the cervix to remove the abnormal cells and allow healthy cellular healing. 

LEEP Procedure is a treatment for high grade dysplasia.  It is done in the office with a local anesthetic block of the cervix.  We use a wire loop electrode to remove the surface abnormal cells of the cervix. The procedure is tolerated very well and no down time is needed, however, many patients prefer to make their appointment at the end of the day and go home after the procedure.  Pelvic rest, no tampons or intercourse, is recommended for two weeks after LEEP to avoid infection risk.  We are removing a 5 mm depth biopsy of the surface of the cervix to remove all the abnormal cells.  Due to a small preterm labor risk associated with LEEP, we do recommend cervical length ultrasounds in pregnancy.