Low grade dyskaryosis and high risk HPV

Hi everyone,

I wonder if anyone can advise me...

I'm 27 and had my first smear a few weeks ago (late I know, I have no excuse!)

I had the results in a letter last week (although I was not around to open them so read them yesterday instead).  They were low-grade dyskaryosis and high risk HPV.  I have been asked to go for a colposcopy and from what I have since read on here and through other searches this is most likely more due to the HPV result than the low grade abnormalities?

I have not called to book my appointment yet due to a very long busy day at work today.

Having read about Lletz treatment I understand that following this you shouldn't swim / wear tampons for 4 weeks afterwards due to the risk of infection.  At this point I have no reason to believe I will need a Lletz but I am wondering if the same advice applies following a biopsy?  And also how likely is it that I will need a biopsy at the time of having the colposcopy with my results so far?

I am asking this because I have a holiday booked in 4 weeks, probably a silly thing to be concerned about but I have read that it is common to postpone Lletz until after holidays because having the procedure can void insurance.  If the same advice applies to a biopsy then should I postpone the colposcopy just in case I need a biopsy?

Less than 2 weeks after returning I will need to go overseas again for work-related meetings, so if I decide to postpone it for travel insurance reasons it will be postponed for around 2 months in total.  Is this advisable / worth the risk?  I don't know how much / how quickly things can change or progress so I have no idea if I should even be worried about postponing?

 

Alternatively - could I have the colposcopy but postpone a biopsy if I need one?  I'm reluctant to ask my GP about this as they tend to be very persistent and I think they might make me go as soon as possible even if it is not necessary (I wasn't given an option about when to go for the smear as the receptionist (who happens to know my mum) called me and shouted at me for not making an appointment yet (again - I have no excuse)).

Sorry for the long message I am not very good at being concise when writing...

 

Yes: it's a relatively recent thing called HPV triage, I believe. So, someone with low-grade dyskaryosis and no high-risk HPV, they'd just ask for a repeat smear in six months. But as they know you have got HPV, they want to keep a closer eye on you. Same as happened to me really!

If you have biopsies taken, you should avoid sex, swimming, tampons and vigorous exercise for a few days; a week at most.

They'd only do LLETZ there and then if they could see something that definitely looked like CIN2 or CIN3. If it looks like CIN1 or 'less than' CIN1 (i.e. just an HPV infection that becomes visible), then they'd want to take biopsies before they treated. They don't like to overtreat, because a lot of CIN1 reverts on its own. They'd probably just want to see you in another six months for another colposcopy.

You'd be completely reasonable, if they did see something they wanted to treat, to delay that treatment and have it at a later date; it's completely up to you and I do think plenty of women delay it to avoid problems with travelling etc. As the smear is only showing mild changes, I think the likelihood is that you will not be recommended LLETZ there and then: mild changes usually corresponds to CIN1. I think they probably will want to take a biopsy or two, because it's a more detailed way of seeing how your cervix is getting on. But in my experience these are NOT painful (they have told me to cough as they take them which must help in some way)and the healing is quick and not disruptive.

So, my personal advice is to go ahead and book the colposcopy now, the sooner the better so the biopsies have definitely healed when you go on hols. Changes on the cervix happen slowly so I doubt the colposcopist would be concerned about you delaying LLETZ by two months IF you need it. But I have to say my guess is that you probably won't be recommended to have it right now.

Ha, I think I have rambled a lot as well! Sorry about that! X

Thank you for your reply!

What you said makes a lot of sense from what I have read before.  I think I was mostly worried about delaying the colposcopy, or the possibility that advice after a biopsy might be the same or similar to advice after Lletz.

I will phone tomorrow to book the colposcopy in that case.

Thank you again,

Laura