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Abnormal Pap Smears

WHAT IS A PAP TEST?

The Pap test, also known as Pap smear, checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can indicate if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer.

During a Pap smear, Dr Gailani takes a sample of cells from your cervix to be tested and examined. A Pap test is safe with no known medical risks.

WHY IS A PAP TEST PERFORMED?

Pap smear or Pap test is conducted as part of a woman's routine health examination, after the age of 21 years. It is not a diagnostic test, but is a screening tool used to detect any abnormal cells in the cervix.

A Pap test can save your life. Pap tests can

If diagnosed early, the chance of curing cervical cancer is very high as treatments can prevent most cases of cervical cancer from developing.

Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and deaths.

DO ALL WOMEN NEED PAP TESTS?

It is important for all women to have annual Pap tests, along with pelvic examinations, as part of their routine health care.

You need a Pap test after age 18-20 years or within 12 months of commencing sexual activity

Currently a pap smear is done every 2 years . This recommendation will change according to new guidelines in 2017.

Women aged 70 can talk to their doctor about stopping after at least 3 normal Pap tests and no abnormal results in the last 10 years.

HOW TO PREPARE FOR A PAP TEST?

Many factors can invalidate test results by washing away or hiding abnormal cells of the cervix. So Dr Gailani suggests that for 2 days before the test you avoid:

  • Douching
  • Using tampons
  • Using vaginal creams, suppositories, and medicines
  • Using vaginal deodorant sprays or powders
  • Having sex

Make sure to empty your bladder just before your examination. Dr Gailani will suggest you schedule a Pap test when you do not have your period.

The best time to be tested is 10 to 20 days after the first day of your last period.

HOW IS A PAP TEST DONE?

Dr Gailani can do a Pap test during a pelvic examination. It is a simple and quick test.

  • While you lie on an examination table, Dr Gailani puts in an instrument called a speculum into your vagina to see the cervix.
  • When Dr Gailani performs the procedure the areas being examined are lumps, sores inflammation, or other abnormalities of the external genitalia.
  • A small disposable swab or soft-bristled “broom” is used to remove cells from the entrance to the canal that connects the cervix with the uterus.
  • The cell sample is placed on a glass slide which is sent to a laboratory for examination under a microscope.

While usually painless, a Pap test is uncomfortable for some women.

WHAT DO ABNORMAL PAP TEST RESULTS MEAN?

Abnormal Pap test results usually do not mean you have cancer. Abnormal Pap smears may indicate the presence of infection or abnormal cells called dysplasia.

Most often there is a small problem with the cervix. Some abnormal cells will turn into cancer if left untreated for a long period of time, but early cell changes can revert back into normal in most of the cases.

By treating these unhealthy cells, almost all cases of cervical cancer can be prevented. If you have abnormal results, then consult with Dr Gailani about what they mean.

Although every effort is made to educate you on pap smears and take control, there will be specific information that will not be discussed. Talk to Dr Gailani about any concerns you have about pap smears.

CAUSES OF ABNORMAL PAP SMEARS

An abnormal pap smear may indicate any of the following:

  • Dysplasia (abnormal cells that may be precancerous)
  • Atrophy or vaginal dryness especially after menopause
  • An infection or an inflammation
  • Herpes
  • Trichomoniasis
  • Recent sexual activity
  • HPV (Human Papillomavirus) infection

SYMPTOMS ASSOCIATED WITH ABNORMAL PAP RESULTS

Usually, abnormal cells do not produce any symptoms. Even the presence of HPV in an abnormal Pap smear is asymptomatic. Therefore, a regular Pap smear is beneficial in early detection of any abnormalities.

An abnormal Pap smear secondary to a sexually transmitted infection may induce the following symptoms:

  • Abnormal discharge from the vagina, such as change in the amount, colour, odour or texture
  • Abnormal sensations such as pain, burning, or itching in the pelvic or genital area during urination or sex
  • Sores, lumps, blisters, rashes or warts on or around the genitals

These results highlight the requirement of supplementary testing to identify and confirm an underlying problem.

TREATMENT ARISING FROM AN ABNORMAL PAP TEST

Often the next step would be a colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to look into the vagina and into the cervix. The colposcope gives an enlarged view of the outer portion of the cervix.

Colposcopy is done when there are abnormal changes in the cells of the cervix as seen on a Pap test. Further, it may be done to assess problems such as genital warts on the cervix, inflammation of the cervix, benign growths or polyps, pain and bleeding.

Read More about COLPOSCOPY

HOW IS AN ABNORMAL PAP SMEAR TREATED?

If the results of the colposcopy reveal a high grade abnormality (CIN II or III) then a LLETZ (Large Loop Excision of the Transformation Zone) is performed. Dr Gailani will perform this as a Day Stay procedure. It involves removing the abnormal cells from the tip of the cervix.

A cone biopsy is performed depending on the type and depth of the lesion.

This specimen is sent for histopathological examination. Complications are uncommon and include infection and bleeding. Most women will experience brown vaginal loss for about three weeks. It is advised that you avoid swimming, intercourse, baths and the use of tampons for this time to minimise the risk of infection.

ABNORMAL PAP SMEAR DURING PREGNANCY

A Pap smear during pregnancy is very safe. In case of an abnormal Pap smear, a colposcopy can be performed during pregnancy. However, further treatments are delayed until the birth of the baby