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  #1  
Old 04-03-2013
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ObGyn Cervical dysplasia screening and follow up?

hello forum members,

i often finding very difficult to understnad about cervical dysplasia followup.........i'm finding difficulty in solving questions at this particular topic too.....so anyone who are much familiar with topic ,can clear my doubt ..i'm ready to discuss regarding this topic..

1)i want the next steps if pt .diagnoses ASCUS/LSIL/HSIL in papsmear.....in adolescent /premenopausal/postmenopausal(age related)......
2)when to do colposcopy directly without doing HPV testing(it's varying from qbank to qbank)
3)when to do follow up papsmear for 6-12 months ....?
4) pregnancy LSIL/ASCUS detected and follow up...?

i'm very much thankful to your valuable responses....
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Old 04-04-2013
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looks like i asked you more questions here.....okay let me tell you what i know...and you guys can clarify me if anything i posted was wrong in it...

1) a 35 yr old female is ASCUS positive on cytology(pap) for first time-------> repeat pap smear in 6 months or do HPV testing (depending on patient -->regular or irregular)------> if HPV positive/ASCUS positive again------>colposcopy and biopsy.................if negative then routine follow up of pap smear every 3 years

2) a woman diagnosed with LSIL on pap smear------------>if A)pre menopausal---->do colposcopy
B) if adolescent------> do follow up in 6-12 months
C) if menopausal-----------> any of them-----colposcopy/ HPV testing or repeat pap smear in 6-12 months(again depending on patient----regular pt. or irregular pt.)
if menopausal HPV/pap smear - positive then colposcopy,if negative then regular follow up in 12 months again

3) pregnancy--------> diagnosed as ASCUS/LSIL on pap smear-----> follow up 6 wks after delivery
diagnosed with HSIL-----> then do colposcopy-----> if no cervical dysplasia changes----then follow up after delivery.....
if severe dysplasia changes seen .....then..????(either conization biopsy /termination of pregnancy /Loop excision method)???/


thank you..
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Old 04-05-2013
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Quote:
Originally Posted by venky2600 View Post
looks like i asked you more questions here.....okay let me tell you what i know...and you guys can clarify me if anything i posted was wrong in it...

1) a 35 yr old female is ASCUS positive on cytology(pap) for first time-------> repeat pap smear in 6 months or do HPV testing (depending on patient -->regular or irregular)------> if HPV positive/ASCUS positive again------>colposcopy and biopsy.................if negative then routine follow up of pap smear every 3 years

2) a woman diagnosed with LSIL on pap smear------------>if A)pre menopausal---->do colposcopy
B) if adolescent------> do follow up in 6-12 months
C) if menopausal-----------> any of them-----colposcopy/ HPV testing or repeat pap smear in 6-12 months(again depending on patient----regular pt. or irregular pt.)
if menopausal HPV/pap smear - positive then colposcopy,if negative then regular follow up in 12 months again

3) pregnancy--------> diagnosed as ASCUS/LSIL on pap smear-----> follow up 6 wks after delivery
diagnosed with HSIL-----> then do colposcopy-----> if no cervical dysplasia changes----then follow up after delivery.....
if severe dysplasia changes seen .....then..????(either conization biopsy /termination of pregnancy /Loop excision method)???/


thank you..
please help me out guys anyone......waiting for reply:sorry:
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Old 12-30-2013
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I'm sorry no one replied. I think ppl didn't know the answer. I hope you got your answer from some where else.
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Old 12-31-2013
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Quote:
Originally Posted by venky2600 View Post
looks like i asked you more questions here.....okay let me tell you what i know...and you guys can clarify me if anything i posted was wrong in it...

1) a 35 yr old female is ASCUS positive on cytology(pap) for first time-------> repeat pap smear in 6 months or do HPV testing (depending on patient -->regular or irregular)------> if HPV positive/ASCUS positive again------>colposcopy and biopsy.................if negative then routine follow up of pap smear every 3 years

2) a woman diagnosed with LSIL on pap smear------------>if A)pre menopausal---->do colposcopy
B) if adolescent------> do follow up in 6-12 months
C) if menopausal-----------> any of them-----colposcopy/ HPV testing or repeat pap smear in 6-12 months(again depending on patient----regular pt. or irregular pt.)
if menopausal HPV/pap smear - positive then colposcopy,if negative then regular follow up in 12 months again

3) pregnancy--------> diagnosed as ASCUS/LSIL on pap smear-----> follow up 6 wks after delivery
diagnosed with HSIL-----> then do colposcopy-----> if no cervical dysplasia changes----then follow up after delivery.....
if severe dysplasia changes seen .....then..????(either conization biopsy /termination of pregnancy /Loop excision method)???/


thank you..

What i have learnt Kaplan)

ASCUS: Options

1. Acclerated pap( 4-6 months)
2. HPV DNA testing .. if HPV 16/18: Colposcopy .. ( if 6/11:repeat pap in 1 yr)
3. In those who you think follow up is uncertain, DIRECT COLPOSCOPY..!!
4. ASCUS again: Colposcopy and biopsy

LSILASC-H; HSIL;CA)
Do Colposcopy and Biopsy..( kaplan)

In Pregnancy:

Abnormal Pap should be evaluated as same way as in non pregnant.(no ECC but).
LSIL: CIN 1 and HSIL: CIN2/3:
CIN gets colposcopy every 3 months. 6-8 post partum, repeat and do definive mgmt.. Severe Dysplasia = CIN3: so colposcopy every 3 months.Any persistent lesion treated post partum only..( later Ablate or excise)

Microinvasion: do cone Biopsyto ensure no frank invasion. Microinvasion Conservative mgmt deliver and reevaluate after 2 months post partum

Invasive ca: < 24 wk: Hysterectory / Radiation
>24 wk: Conservative till 32-33 wk then do C/S. and do defenitive mgmt...
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Last edited by Janakpriya; 12-31-2013 at 03:59 AM.
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Old 01-01-2014
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Default Kaplan and UW explanations are different!

Hey guys! I am also confused..right now studying Gynae from Kaplan, MTB's, and UW. BUT!!! The management for cervical CA is different in UW explanations than in Kaplan. If you guys noticed, in UW, management for ASCUS is according to age..(Adolescent female, Premenopausal, Postmenopausal). But in Kaplan, there is no such management according to age..Am I the only one here who's confused?? Should I go to USPTF website and confirm the screening and management for cervical CA??

Any comments are most welcome!! Thank YOU!
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Old 01-01-2014
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Default Link to a thread on this forum..

Cervical Cancer Screening Algorithms
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