Fredrick H. Creutzmann, M.D.  www.DrCmd.com

Obstetrics, Gynecology and Infertility
4323 North Josey Lane
Plaza I, Suite #203
Carrollton, Texas 75010
972-394-7277

As we have discussed, your last Pap smear has been reported as "abnormal". As a screening test, a Pap smear does not give the complete picture and it is difficult to find out the condition of the cervix by simply looking at it with the "naked eye". You need to have a colposcopic exam performed to look closely at the cervix to find out what type of abnormal cells they are and where the abnormal cells are coming from. This exam is usually done between menstrual periods and generally takes about a half-hour. A woman lies down in the position used to take a Pap smear and a speculum is inserted into the vagina to give a view of the cervix and vagina.

Colposcopy is a painless examination of the cervix and vagina with a low power microscope. This exam is generally done by a Gynecologist because of the training required to detect subtle blood vessel changes that are associated with pre-cancerous cells. Basically, pre-cancerous cells are cells, that for whatever reason, are dividing and multiplying too rapidly. These rapidly multiplying cells push blood vessels out of their way. This creates recognizable patterns in the configuration of these blood vessel and this is what is examined for. The magnified view of the cervix may also show everything to be normal, but if abnormal areas are found, the colposcope can be used to decide from which areas a biopsy should be taken.

A biopsy of the cervix is the removal of a small piece of tissue (about the size of a grain of rice) from the cervix using a specially designed instrument. This tissue is then sent to a laboratory where it is examined under a microscope by a Pathologist. He (or she) is a medical doctor trained in diagnosing medical problems by examining microscopic cellular structures under the microscope.

Most women describe the procedure as feeling like a sharp pinch. Some experience a menstrual-like cramp. I recommend taking a couple of 200 mg ibuprofen tablets (Advil, Nuprin, Motrin, etc.) before coming to your appointment; this can almost eliminate the discomfort. There may be slight spotting or bleeding for a few days after a cervical biopsy, but normal activity can be resumed within an hour of the procedure. If biopsies are required then sexual activity should be avoided for a week.

If pre-cancerous changes are found on the biopsy there are several ways that they can be treated. I generally freeze away these areas if they are small. Larger areas can be treated with electricity or laser to remove the area. The long-term cure rates of these treatment methods are good, but not absolutely perfect. Close follow-up will be required, with regular pap smears and possibly additional colposcopy no matter how the abnormality is treated.