The most common cause of an abnormal Pap smear is the presence of the sexually transmitted human papilloma virus, or HPV, according to the United States Department of Health and Human Services. A Pap smear checks for abnormal changes in the cells of the cervix, the lower part of the uterus that opens to the vagina. An abnormal Pap smear does not mean a woman has cancer, but it does help identify precancerous changes called dysplasia. Physicians classify dysplasia as mild, moderate or severe. In the event of an abnormal Pap smear, physicians will discuss the possible options for identifying and treating the cause.
Repeat Testing
Physicians may choose to treat mild cervical dysplasia by waiting three to six months and then repeating the Pap smear. In many cases, the cervical changes will disappear without treatment before the second test. The American Congress of Obstetricians and Gynecologists says that women 21 years of age and older should be tested every six months following an abnormal Pap smear until they have two normal results. In women 20 years and younger, a case of mild dysplasia will be monitored once a year.
HPV Testing
Many strains of the HPV virus cause cervical cancer. Women may opt for an HPV test to detect the presence of the cancer-causing HPV in cells. In many cases, the lab can use the cells from the initial Pap smear to avoid a second doctor's visit.
Colposcopy
If a woman has an abnormal Pap smear with a high grade of dysplasia, physicians will often perform a colposcopy. A colposcopy allows physicians to view the cervix in more detail through a magnifying device, according to MayoClinic.com. The colposcopy's magnification allows physicians to pick up cervical changes that they can miss with the eye alone. Physicians may choose to perform a biopsy following the identification of abnormal cells.
Biopsy
A biopsy allows doctors to remove a small sampling of tissue to examine it under a microscope. Most often, a physician will remove the tissue in the office during the colposcopy. This form of biopsy requires no sedation, anesthesia or recovery time, though it may be a bit uncomfortable.
Physicians may choose a more invasive procedure known as a cone biopsy. During a cone biopsy, a physician removes a cone shaped sampling of the abnormal cervical tissue. Doctors perform this procedure in a hospital or outpatient center under general anesthesia. The procedure has a short recovery time, and patients can go home the same day. In many cases, removal of the abnormal cells for study actually removes all of the abnormal tissue, and no further treatment is necessary.
Treatment Options
There are several options available to treat cervical dysplasia. The treatment a physician uses largely depends on the level of dysplasia. Physicians may opt to perform a LEEP, or loop electrosurgical excision procedure. A LEEP uses a thin wire loop carrying a current to remove a thin layer of the cervix. Doctors may perform a LEEP in the office under local anesthesia. After the procedure, patients may experience watery, pinkish discharge or brown discharge from a paste used to stop bleeding.
Cryotherapy is another option for cervical dysplasia treatment. Cryotherapy involves using a device called a cryoprobe to freeze the abnormal tissue, which later sheds. There are risks associated with each of these procedures, and women should discuss them in detail with their physician.
