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Date of last update: 10/14/2017.

Forum Name: Gynecology

Question: Moderate Dysplasia

 heatherbradley - Fri Dec 31, 2004 11:14 pm

I had a routine pap smear in November of 2003. The results were abnormal. I then had a follow up in May, 2004, also abnormal. From there I had a follow up in July, also abnormal. At this time I found out that I had moderate dysplasia. The Leep procedure was performed at this time. Recently, I went for my follow up. Again, i receive a telephone call from my gynocologist explaining that this came back as moderate dyspladia. I do not go back into find out the next step until next week. Does anyone know what the normal procedure would be, or how long this could go on.
 Dr. Tamer Fouad - Sat Jan 01, 2005 5:56 am

User avatar In CIN 2, or moderate dysplasia around half of the epithelial layer is abnormal. It is less likely to regress back to normal on its own than CIN 1 (mild dysplasia), although it will do so 40-50% of the time. About 20-30% of the time, moderate dysplasia will progress to severe dysplasia, and about 20% of the time it will persist. Most physicians prefer to treat moderate dysplasia, although it is possible to wait and monitor it to see what the course will be.

LEEP stands for Loop Electosurgical Excision Procedure. An electrical current is passed through a wire loop which is used to remove dysplastic tissue from the cervix. An advantage of LEEP is that the tissue is preserved for examination (unlike cryotherapy and laser ablation).
A LEEP is sometimes also used to get a better tissue sample, if a punch biopsy was inadequate to make a definite diagnosis.
What's Next? The Options:
1) If margins are clear (indication that all the dysplasia was removed), follow up with Paps and checkups.
2) If margins aren't clear, options are:
a) Watch and wait (follow-up Paps)
b) Cone Biopsy
3) If cancer is found, cancer assessment.

A cone biopsy is a surgical procedure aimed at getting a cone-shaped sample of the cervix within the endocervical canal to accurately diagnose, and sometimes treat, cervical dysplasia or early cervical cancer.

You must continue these follow ups because of the real chance of progression.
 heatherbradley - Sat Jan 01, 2005 10:13 am

I do plan on following up on this. I guess I just don't understand why it came back again. I was told before that it was all removed.
 Dr. Tamer Fouad - Sat Jan 01, 2005 10:21 am

User avatar You should discuss with your doctor the factors that cause CIN. The exact cause of CIN is still unknown. However, the main cause is infection of the cervix with certain types of human papilloma virus (HPV). HPV (often known as wart virus) is a very common infection. There are over 100 types of the virus and the commonest types can cause warts on the hands or verrucas on the feet. Some types can affect the genital area including the cervix.

Women who smoke are about twice as likely to develop CIN as non-smokers.

There is also some research to suggest that women who take the contraceptive pill for longer than 10 years are slightly more likely to develop cervical cancer. If you are concerned about taking the pill, please discuss it with your GP or family planning clinic.

If any of these factors are present and are not stopped CIN will most probably recurr.

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