Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. In women who have had a hysterectomy and do not have a cervix, they may develop vaginal dysplasia. This is why women who have had a hysterectomy should still have screening Pap smears. Dysplasia is not a cancer but is considered a precancerous condition. This means, if left untreated, dysplasia may develop into a cancer.
Dysplasia is categorized depending on the level of changes in the cells.
CIN I – mild dysplasia (few abnormal cells present)
CIN II – moderate dysplasia
CIN III – severe dysplasia or carcinoma in situ
The most common cause of an abnormal Pap smear/dysplasia is the human papilloma virus (HPV). This is a sexually transmitted disease that has many different types, some viral types commonly cause genital warts. Therefore symptoms may present differently in each person with the virus. However, people may never get warts but present with only an abnormal Pap smear. This is commonly the first time they know they carry the virus. Sexual partners may carry the virus as well without being aware because they do not present with symptoms. This virus may be asymptomatic for any period of time, so it is difficult to identify the partner who carried it in those who have had multiple sexual partners. Unfortunately, there is not a cure for this virus therefore it is possible for symptoms to recur resulting in abnormal pap smears. There is no clear reason for what causes recurrence, but increased risk factors have found to be smoking and decreased/compromised immune systems such as HIV, lupus, stress, or infection.
Risk factors for cervical dysplasia include: sexually transmitted diseases, especially HPV or HIV infection, multiple sexual partners, starting sexual activity before age 18, having children before the age of 16, and DES exposure.
A colposcopy may be performed to confirm the dysplasia and attempt to determine the extent on the cervix or vagina. A coloposcopy is a procedure which uses a low-power microscope to magnify the surface of the cervix 10 to 40 times its normal size. This helps the practitioner see abnormal areas on the cervix/vagina. If abnormal areas are visualized, a biopsy may be done to confirm and specify the grade of dysplasia. If you have a heart murmur let your doctor know before the procedure. A colposcopy is painless however, if a biopsy is done, you may feel some cramping during and after the procedure. The biopsy results usually return in 1 -2 weeks. The results will help guide your physician through your treatment plan. This may include monitoring, repeat Pap smear, or a more extensive biopsy called a cone biopsy which is done under anesthesia.
The treatment depends of the degree of dysplasia. Mild dysplasia may be monitored because it often resolves on its own. Other treatments options may include CO2 laser, cold knife conization, or LEEP procedure.
To view diagrams of these procedures please click on the links below:
http://adam.about.com/encyclopedia/Cervical-neoplasia.htm?once=true?
http://adam.about.com/encyclopedia/Cervical-cancer.htm?once=true
http://adam.about.com/encyclopedia/Cervical-dysplasia-series.htm?once=true
http://adam.about.com/encyclopedia/Cervical-biopsy_1.htm?once=true
http://adam.about.com/encyclopedia/Colposcopy-directed-biopsy_1htm?once=true
