After Pap, aku kena tunggu result dari lab for three days. On third day, Dr Aziani call and wanted to see me. Aku dah budget, ni mesti ada yang tak best ni. Masa jumpa Dr.Aziani, she explained how to read a pap smear report. Basically macam ni (from my understandinglah), dalam pap smear report ni ada 4 category which class 1,2,3 & 4. If class 1 & 2, basically the result is okay, just repeat pap smear untuk next2 year. But if class 3&4, result shows that there was an abnormalities in Pap smear test. In this class, Dr. advise to do a copolcospic biopsy dekat hospital. In my case, i was in class 4!.So Dr. Aziani tulis referal letter to do the biopsy and again aku pilih HUKM jugak sebab dah banyak history aku kat situ.
On 17 December 2008, aku buat colposcopic biopsy tu, caranya lebih kurang mcm ni lah, dia masukkan wayar mcm camera tu untuk tengok tisu2 kat pangkal rahim tu,so kita pun bleh tengok skali kat skrin tv tu. Then die spray liquid yg macam cuka (kita akan rasa pedih la time tu) dekat cervix area tu, klu permukaan/tisu2 kat cervix tu turns into white, meaning that memang ada unhealthy tisu kat situ. And dr. need to remove those infected area by doing a minor surgery called LEEP (Loop Electrosurgical Excision Procedure),ni haku explain di lain tajuk. Masa buat biopsy tu, dr ambik sket tisu/daging di permukaan cervix tu untuk dihantar ke lab. After 2 weeks, the result shows that aku CIN II . Sebab Cervival Intraepithelial neoplasia ni ada 3 categories; CIN I, II, III. Kat bawah ni aku excerpt artike dari 'MedlinePlus Medical encyclopedia' pasal Cervical Dyslplasia.
Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix
Definition Return to top
Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, this is considered a precancerous condition.
Cervical dysplasia is grouped into three categories:
- CIN I -- mild dysplasia (a few cells are abnormal)
- CIN II -- moderate to marked dysplasia
- CIN III -- severe dysplasia to carcinoma-in-situ (precancerous cells only in the top layer of the cervix)
Causes Return to top
Most cases of cervical dysplasia occur in women aged 25 to 35.
The cause is unknown. However, the following may increase your risk:
Symptoms Return to top
There are usually no symptoms.
Exams and Tests Return to top
A pelvic examination is usually normal.
A Pap smear shows abnormal cells. A colposcopy-directed biopsy is done to confirm the condition and determine its severity.
Other tests may be done to find out if the abnormal cells have spread outside the cervix:
- Endocervical curettage
- Cone biopsy
Treatment Return to top
Treatment depends on the degree of dysplasia. Mild dysplasia may go away on its own . You may only need careful observation by your doctor with repeat Pap smears every 3 to 6 months.
Treatment for moderate to severe dysplasia or dysplasia that does not go away may include:
- Laser vaporization to destroy the abnormal tissue
- Surgery to remove the abnormal tissue
Women with dysplasia need consistent follow-up, usually every 3 to 6 months or as recommended by their provider.
Outlook (Prognosis) Return to top
Early diagnosis and prompt treatment cures nearly all cases of cervical dysplasia.
Without treatment, 30-50% of cases of severe cervical dysplasia may lead to invasive cancer. The risk of cancer is lower for mild dysplasia.
Possible Complications Return to top
The condition may return.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if you are a woman who is sexually active or aged 20 or older and you have never had a pelvic examination and Pap smear.
Risks Associated with Pregnancy After LEEPThe risks associated with LEEP and pregnancy are:
- Cervical Incompetence.When a woman's cervix is diagnosed as "incompetent," it means the cervix is unable to stay closed during a pregnancy. Cervical incompetence can result in miscarriage and pre-term labor. However, a cervical cerclage can be done to ensure the cervix remains closed during the pregnancy. A cerclage basically means that the cervix is sewn closed for the duration of the pregnancy. Only a small percentage of woman who have had a LEEP will require a cerclage in pregnancy.
- Cervical Stenosis. Cervical stenosis is the tightening and narrowing of the cervix. This can cause the cervix difficulty in dilating during labor.
- Infertility. Although extremely rare, a LEEP may cause a woman to become infertilee. However, research on LEEP and fertility is very limited.
References Return to top
Noller KL. Intraepithelial Neoplasia of the Lower Genital Tract (Cervix, Vulva) : Etiology, Screening, Diagnostic Techniques, Management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap. 28.
Wright TC Jr, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ; ASCCP-Sponsored Consensus Conference. 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002 Apr 24;287(16):2120-9. Review.
Hoffman MS, Martino MA. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol. 2004 Sep;191(3):1049Update Date: 5/26/2008