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Pap results HSIL high risk HPV
Hi
I had a pap come back as high risk HPV and HSIL. I went in for a colposcopy and they said the results were negative and he said I didn’t test positive for a high risk strain. He said I could have the LEEP procedure done still and find out what strain I have or I could wait 6 months and retest. These results are confusing especially after a bad pap result and my biopsy results were completely different. What does this mean?
Thank you!
I had a pap come back as high risk HPV and HSIL. I went in for a colposcopy and they said the results were negative and he said I didn’t test positive for a high risk strain. He said I could have the LEEP procedure done still and find out what strain I have or I could wait 6 months and retest. These results are confusing especially after a bad pap result and my biopsy results were completely different. What does this mean?
Thank you!
Samples sometimes get mixed up at the lab so it is possible that those are actually someone else's results. Since the colposcopy was negative, doing a LEEP seems overkill. Maybe you could just have another pap done in 6 months or a year. Have you kept up with paps (every 3 years or every 5 years if also doing HPV testing) and don't have a history of dysplasia (LSIL, HSIL, CIN1,2 or 3)? If so, then a lab mix-up would seem even more reasonable.
3 Comments
The only thing on my history is low risk HPV in 2020 and the dr didn’t even tell me. I’m still sick over all this. Depression has set in I think. I ended a relationship I was in because sex is the last thing on my mind after this ordeal. I seriously don’t think I’ll ever start a relationship again. I don’t want anyone knowing I have it and I feel obligated to tell a future partner. So therefore I’m not even going to date. Dr says it will never go away.
Maybe it would be worthwhile to get a second opinion. Getting a copy of your records would be helpful. HPV is very common so there's no shame in it. According to this article - https://www.healthline.com/health/sexually-transmitted-diseases/does-hpv-go-away#does-it-go-away - "Most strains of HPV go away permanently without treatment" so I don't know why your doctor said "it will never go away."
Please don't allow this to take over your life. It likely isn't anything serious. Seek out more information...knowledge is power. Hugs!
Please don't allow this to take over your life. It likely isn't anything serious. Seek out more information...knowledge is power. Hugs!
I'm sorry you ended your relationship over this. Up to 90% of us will have it at least once in our lifetimes, and your test is saying you don't have it anymore. I bet if you talked to your friends - and I'm not suggesting you do, if you aren't comfortable with it - the vast majority of them will have had it. I think I know 2 woman who haven't, and both married their first sexual partners, who also had no other partners.
I definitely agree that you need a second opinion - and maybe a new doctor. I'm sorry. Please don't let this cause depression - it's not worthy of it. Talk to a counselor, and find a new doctor.
I definitely agree that you need a second opinion - and maybe a new doctor. I'm sorry. Please don't let this cause depression - it's not worthy of it. Talk to a counselor, and find a new doctor.
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So the colposcopy looks for signs of disease on your cervix, vagina and vulva. It's not an HPV test. They must have done a biopsy and didn't find any abnormal cells or cancer. I have to say, I'm confused by your results, too. Your Pap results indicated abnormal cells, and your colpo found none.
(This is a good list of the possible results of a colpo and what they mean - https://www.nhs.uk/conditions/colposcopy/results/)
With your pap test, did they do a separate HPV test? That is usually done at the same time as the Pap, and would tell you what strains you have.
I'm a little confused as to why he would suggest a LEEP when the colpo found nothing, and when an HPV test would tell you what strains you have, in a far less invasive way. Can you get a copy of your test results? Is there a patient portal? Can you ask? You're entitled to a copy of all your records.
I'm sorry it's so confusing.
(This is a good list of the possible results of a colpo and what they mean - https://www.nhs.uk/conditions/colposcopy/results/)
With your pap test, did they do a separate HPV test? That is usually done at the same time as the Pap, and would tell you what strains you have.
I'm a little confused as to why he would suggest a LEEP when the colpo found nothing, and when an HPV test would tell you what strains you have, in a far less invasive way. Can you get a copy of your test results? Is there a patient portal? Can you ask? You're entitled to a copy of all your records.
I'm sorry it's so confusing.
10 Comments
Hi
Thanks for the reply! Yes they did the biopsy and he said it was negative. He said he was suggesting the LEEP to get rid of the lesions?
And I’m thinking they didn’t do a hpv test with it because he said he could do another test to see being the biopsy came back negative for the high risk strain.
They don’t have an online portal I wish they did. He read my initial report to me over the phone and it said moderate to severe dysplasia.
He gave me the choice to wait for the LEEP because he said the dysplasia could go away. I felt like I shouldn’t go through all of that if I didn’t indeed have to. So confusing!
Thanks for the reply! Yes they did the biopsy and he said it was negative. He said he was suggesting the LEEP to get rid of the lesions?
And I’m thinking they didn’t do a hpv test with it because he said he could do another test to see being the biopsy came back negative for the high risk strain.
They don’t have an online portal I wish they did. He read my initial report to me over the phone and it said moderate to severe dysplasia.
He gave me the choice to wait for the LEEP because he said the dysplasia could go away. I felt like I shouldn’t go through all of that if I didn’t indeed have to. So confusing!
Wow, this is confusing.
Okay, so the colpo isn't actually negative - just negative for HPV. Did you get a result like CIN 1 or CIN 2? I think you need some clarification. Making a decision about a LEEP would be really hard without knowing the exact results of the colpo. Moderate to severe would be CIN 2 or CIN 3 and usually a LEEP is recommended.
Can you call him and ask what the exact results were? A nurse should be able to answer that question for you.
And the exact strains of HPV don't matter, ultimately. If it's high risk, it's probably 16 or 18, which are the 2 most common strains. It won't make any difference in a treatment plan.
Did he talk to you about the HPV vaccine? That can help protect you against getting other common strains. It's been approved for people up to age 45.
Okay, so the colpo isn't actually negative - just negative for HPV. Did you get a result like CIN 1 or CIN 2? I think you need some clarification. Making a decision about a LEEP would be really hard without knowing the exact results of the colpo. Moderate to severe would be CIN 2 or CIN 3 and usually a LEEP is recommended.
Can you call him and ask what the exact results were? A nurse should be able to answer that question for you.
And the exact strains of HPV don't matter, ultimately. If it's high risk, it's probably 16 or 18, which are the 2 most common strains. It won't make any difference in a treatment plan.
Did he talk to you about the HPV vaccine? That can help protect you against getting other common strains. It's been approved for people up to age 45.
It sure is!
I’ll have to call and get copies. He told me the biopsy was negative and that I didn’t have those strains. There’s no abnormal cells to remove. I brought it up to a friend that was a obgyn nurse her whole life and she said sometimes the Pap smears can be read wrong and to trust the biopsy report and to make sure I go to every appointment to make sure nothing happens down the road. It’s kinda worrisome to have a bad pap report but then a good biopsy.
He didn’t say anything about the vaccine being I’m 43 I’m surprised he didn’t mention it.
He said he felt obligated to do the LEEP so he could tell me what strain but why not just do another test then instead of the LEEP. A few people have said not to do it if it’s not needed right now.
I’ll have to call and get copies. He told me the biopsy was negative and that I didn’t have those strains. There’s no abnormal cells to remove. I brought it up to a friend that was a obgyn nurse her whole life and she said sometimes the Pap smears can be read wrong and to trust the biopsy report and to make sure I go to every appointment to make sure nothing happens down the road. It’s kinda worrisome to have a bad pap report but then a good biopsy.
He didn’t say anything about the vaccine being I’m 43 I’m surprised he didn’t mention it.
He said he felt obligated to do the LEEP so he could tell me what strain but why not just do another test then instead of the LEEP. A few people have said not to do it if it’s not needed right now.
Oh my god, I get more and more confused by this.
Okay, so the pap came back with moderate to severe dysplasia, but the colpo and biopsy didn't show any of that? And now he wants to do a LEEP just to tell you what strains of HPV you have? I've never heard of that. Ever.
LEEP can be used to diagnose HPV, but with the HPV test now, it's not used for that. If you have abnormal cells on the colpo/biopsy, the LEEP can help determine what is causing them, and can find HPV, but it's not used strictly to diagnose what strain.
I might get another pap in 3 months AND the HPV test this time, and see what happens. I can't make your decision for you, but I don't think I'd get a LEEP right now.
The FDA approved the vaccine for up to 45 in late 2018, but it seems it missed a lot of doctors.
https://www.fda.gov/news-events/press-announcements/fda-approves-expanded-use-gardasil-9-include-individuals-27-through-45-years-old
https://www.cancernetwork.com/view/fda-approves-gardasil-9-for-prevention-of-oropharyngeal-head-and-neck-cancers-caused-by-hpv
Okay, so the pap came back with moderate to severe dysplasia, but the colpo and biopsy didn't show any of that? And now he wants to do a LEEP just to tell you what strains of HPV you have? I've never heard of that. Ever.
LEEP can be used to diagnose HPV, but with the HPV test now, it's not used for that. If you have abnormal cells on the colpo/biopsy, the LEEP can help determine what is causing them, and can find HPV, but it's not used strictly to diagnose what strain.
I might get another pap in 3 months AND the HPV test this time, and see what happens. I can't make your decision for you, but I don't think I'd get a LEEP right now.
The FDA approved the vaccine for up to 45 in late 2018, but it seems it missed a lot of doctors.
https://www.fda.gov/news-events/press-announcements/fda-approves-expanded-use-gardasil-9-include-individuals-27-through-45-years-old
https://www.cancernetwork.com/view/fda-approves-gardasil-9-for-prevention-of-oropharyngeal-head-and-neck-cancers-caused-by-hpv
Crazy confusing isn’t it? They are sending me copies of all my results. I will post exactly what they say when I get them. They don’t have a patient portal. I wish they did. I think it’s time to switch drs lol this is nuts!
My doctors have a patient portal - most of them are under the same big medical organization, and half of them don't update it with current info, so the portal only helps if they update it lol. My regular doc is great about it. My allergist is so not, and my gyno is good about 1/2 the time. I'm not sure my ENT knows it exists. Sigh. It shouldn't be this hard.
Keep me posted, for sure. :)
Keep me posted, for sure. :)
Hi! I got my records. One report says abnormal HPV low risk in feb 2020 (note...they didn’t even tell me!!!!) but the lab report says HPV e6/e7 detected and then it says not detected.
Lab report from this time says Thin prep. Abnormal cells HSIL but colposcopy/biopsy report says both samples were negative for dysplasia.
Lab report from this time says Thin prep. Abnormal cells HSIL but colposcopy/biopsy report says both samples were negative for dysplasia.
I don't even understand lol.
Okay, so HPV e6/e7 are high risk strains. I have no idea what to make of the detected/not detected, or the low risk.
Maybe you had a false positive pap this time? I can't tell you what to do, but if it were me, I'd not do the LEEP yet. I might get another pap in 3 or 6 months. Definitely don't wait a year, though.
I'm sorry this is so confusing. It shouldn't be. :(
Okay, so HPV e6/e7 are high risk strains. I have no idea what to make of the detected/not detected, or the low risk.
Maybe you had a false positive pap this time? I can't tell you what to do, but if it were me, I'd not do the LEEP yet. I might get another pap in 3 or 6 months. Definitely don't wait a year, though.
I'm sorry this is so confusing. It shouldn't be. :(
I told them I was going to wait the 6 months and retest. I wish I could send you a couple of my records. It’s definitely confusing. Basically in 2020 it said low risk HPV. The pap I had this year said abnormal and HSIL. Colposcopy/biopsy came back negative for dysplasia and high risk HPV. I’m wondering myself if my pap was a false positive.
I mean, it's kind of sounding like that to me. I can't think of another logical reason for all this. If you want to post images of your records on imgur or something, I'm happy to look at it. Just be sure to block out any identifying info, like your name, your doctor's name, your birth date, location, etc.
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