Cervical biopsy abnormal, what to expect

[HappyWithLife]

I had a smear test which came back abnormal. I went for a colposcopy and biopsy and the results came back as needing further treatment. I'm told this involves 4 anaesthetic injections into the cervix and then the affected cells will be burnt away. What should I expect? I know this is fairly common stuff, but I'll be going alone and have to find my own way home afterwards and am wondering if I'll be in any pain or if the bleeding will be heavy etc? Also do the after effects linger or is it all over and done with? Any experience anyone?

Hi

I had this and i found this the easy part. The injections are short sharp little jump ow! ow! ow! ow! Then nothing. My legs were a little wobbly after and there was a little bleeding plus mild pain (i only took a couple of paracetamol).

Good luck - you should be fine. Just remember what you are preventing

mrspear...thanks for your message. I'm really not unduly worried about it, and even if it were painful etc it is still a million times better than what could happen if I hadn't gone for the smear. I was just wondering if I'll be ok on my own afterwards because they told me on the phone to make sure I have someone to drive me home afterwards. I'm a single mum so have no one around to help, but I have 2 teenagers who will be there when I get home.

Might be better to get a taxi than drive yourself or walk a long way, if you can. The 2nd time I had LLETZ (cutting out the affected cells with a heated wire and then cauterising (burning) the wound), they took quite a deep chunk out of my cervix and suggested that driving and walking about too much might provoke it to start bleeding again, as they had had a hard time trying to stop it bleeding in the first place. The first time I had it done, there was no such issue - it hardly bled at all and I ignored the advice to have someone to take me home and walked part way then drove the rest without ill effect. There is also the possibility, however, that the local anaesthetic and procedure will have affected you mildly and made you feel slightly light headed and wobbly, so driving yourself might not be a good idea if you can get home another way. I don't remember it being particularly painful afterwards either time, just very crampy, although the bleeding was a pita after the 2nd time and went on for over two months. I don't think that's the norm, though.

You won't be able to use tampons or a mooncup for at least 4 weeks so stock up on pads. It can be quite achy/crampy for a few days too.
For a few days-a week afterwards you may find some small dark brown fragments or little bits of tissue on the pads too.
When they say 'burnt away' they usually mean LLETZ which as rabbitstew said is removal of the affected area.

There's more information about treatment here and here.
I've had a LLETZ and felt quite wobbly afterwards, also had stiff legs and back too. I felt fairly reasonable the day but really drained so was off work. It was a bit odd as I work in a screening lab so weird to be on the other side of it.
Hope it goes ok.

BelaLugosiNoir would you be so kind as to explain something to me? I have just been diagnosed with Cin 1 and am awaiting an appointment for a coloposcopy. Is this to make sure that the original diagnoses is correct and what is the purpose of the biopsy? Thanks.

Hi, the CIN grades are to do with cell changes, with 1 being the least affected up to 3 being the most. The biopsy is to check that it isn't cancer, which in most cases it isn't. I am CIN2, and although I need treatment it is not cancer, although there's a good chance that if I didn't have them removed it may well develop into it. HTH

Hi Tilly
When you say you've been diagnosed with CIN1, is that from a Pap (smear) test result?

The Pap test is a screening tool not a diagnosis. In the lab we're looking at the cells scraped from the surface of the cervix which gives a good idea of what's going on, but not a complete one.
Colposcopy is the next stage for investigating an abnormality. It is a more detailed look at the cervix using a special microscope, a mild vinegar solution is applied to the cervix which shows up very active areas really well. From this the colposcopist can make a further assessment and decide whether to take an investigative biopsy (usually a few mm in size) or a treatment (excision) biopsy (often called LLETZ, LEEP or loop).

The biopsy removes a small piece of cervix, and the difference from a smear, it that it goes further into the tissue, so a full picture of what is happening in the cervical tissue can be seen under the microscope.
CIN= Cervical Intraepithelial Neoplasia and is pre-cancerous changes. They can resolve untreated, but the more abnormal they get, the less likely they are to go away on their own.
The link earlier is to the colposcopists' association website which has a useful FAQ.

Thank you Happy with Life and BelaLugosiNoir
for your explanations. It is a lot clearer now! And yes Bela I was diagnosed with a Pap smear.

Ah ok, so as I've said above it's not strictly a diagnosis, and the test would usually be reported as mild dyskaryosis. Cytology (pathology speciality) uses the term 'dyskaryosis' for abnormal cells and its a way of described the cells that have been scraped from the area of CIN on the cervix. A biopsy is then examined - which is histology (also a pathology speciality) also under the microscope.
Mild dyskaryosis does usually equate to CIN1 but as my earlier post its not a complete picture due to the limitations of sampling, hence the further investigation.
Hope it goes well for you :)

Thanks again Bela for explaining everything so clearly. You are an asset to Mumsnet!

I had CIN 3 and wimped out of the local painkiller and had an GA for the LLETZ so you could do that if you are concerned about being awake during the treatment. The consultant was fine about it and they did a hysteroscopy at the same time. The GA only lasted 30 minutes and while it was scary I did feel well rested afterwards.

Hi Tilly, thank you