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Cervical smear abnormality and colposcopy: Treatment, symptoms, advice and help

About cervical smear abnormality and colposcopy

Cervical smear abnormality is generally encountered during routine Pap smear examinations. This abnormality may be cancerous or non-cancerous. Colposcopy is an investigation where an instrument named colposcope is used to examine the interior of the cervix. Both cervical smear examinations (Pap smear) and colposcopy are investigations to diagnose any abnormal pathology of the cervix, which forms part of female reproductive system and located in the lower part of uterus.

Cervical smear abnormality and Colposcopy: Incidence, age and sex

Cervical smear abnormality is commonly encountered during routine gynaecological examination. Although it may be seen in any age group, it mainly exhibits in young and middle aged women.

Signs and symptoms of cervical smear abnormality and colposcopy: Diagnosis

The clinical features depend upon the causative factor behind abnormal cervical smears. Some common clinical features of the vaginal infection include vaginal discharge which may be typical of the causative organism. For example, a curdy white discharge is seen in candidiasis and a greenish vaginal discharge with fishy odour is characteristic of trichomoniasis. Cervical smear abnormality may also be seen in the cancerous condition of the cervix wherein the patient may present with foul-smelling vaginal discharge, vaginal bleeding between periods, pelvic pain, bleeding and pain after sexual intercourse along with loss of weight and fatigue.

Such symptoms usually warrant a Pap smear examination which should be ideally repeated, if abnormal. Then colposcopy of cervix is done which helps in examining the interior of cervix. This may be followed by endocervical curettage and cervical biopsy.

Causes and prevention of cervical smear abnormality and colposcopy

The cervical smear abnormality may be seen in several instances which may range from mild problems to serious health problems. Following are some common causes resulting in abnormal smear:

  • Simple vaginal infections like candidiasis, trichomoniasis
  • Benign warts as a result of human papilloma virus
  • Pre-cancerous state of cervical cells, also called dysplasia
  • Cervical cancer

Cervical smear abnormality and colposcopy: Complications

The most dreadful complication of cervical smear abnormality is cervical cancer. Very rarely colposcopy or colposcopic directed biopsy may result in vaginal bleeding.

Cervical smear abnormality and colposcopy: Treatment

The treatment of an abnormal cervical smear depends on its cause. Thus it is essential to evaluate the cause of this abnormality before embarking upon the treatment plan. Vaginal warts or dysplastic cells may be eliminated by procedures like cryosurgery, laser treatment and cone biopsy. Sometimes electrified loop excision called LEEP may be considered since it can be done under local anaesthesia and gives better results. Vaginal infections should be treated with appropriate medications. Hysterectomy may be considered in cases of severe dysplastic cells, especially in women who have completed their families. If Pap smear and colposcopic directed biopsy reveals cancer of the cervix, then, appropriate treatment plan involving surgery, chemotherapy or radiotherapy should be chalked out.

The treatment modalities include chemotherapy, radiotherapy and surgery. Surgical intervention wherein the cervix is removed along with the uterus is the treatment of choice. This may be coupled with radiation or chemotherapy as and when needed. The drug, namely cisplatin is generally the most common chemotherapeutic medication prescribed to the affected individual. Regular follow up is recommended for detecting any relapses, which may occur in the future.