Pap smear
Pap smear is a screening test for precancerous or cancerous pathologies of the cervix.
These conditions are related to the activation of a virus previously contracted from the Human Papillomavirus (HPV) family. Only some of them have a tropism for the cervix. This infection is contracted during sexual intercourse.
The pap smear looks for abnormalities in the cervical cells and identifies the responsibility of the HPV virus.
To do this, a small brush is rubbed directly on the cervix. The product will be recovered on microscope slides or in a specific liquid for analysis.
It is recommended to start Pap smears at the age of 25. A new Pap smear is done the following year. If it is normal, the procedure should be repeated every 3 years.
If you have had an abnormal Pap smear once in your life, you will have to take a new one every year.
Low-grade smear (LSIL)
The virus is latent in the deep layers of the cervix.
No triggering factor for its activation is known today except smoking.
Active infection results in abnormalities in the architecture of the cervix cells themselves and in the architecture of the tissue.
That’s why the Pap smear can detect them.
There is a graduation in the severity of the anomalies. The least severe anomalies are called “low-grade” anomalies.
It will then be necessary to perform a colposcopy without urgency.
The ascus smear
Abnormalities in cervical cells can be detected with no detection of papillomavirus.
When these anomalies are not very severe, they are referred to as ASCUS (Atypical Squamous Cells of Undetermined Significance) Pap smear.
A second examination will be performed at the laboratory to determine the presence or absence of a particular HPV virus on the cervix. They are oncogenes viruses, i.e. those of Papilloma which have a tropism for the cervix.
High grade smears (HSIL)
The virus is latent in the deep layers of the cervix.
At the moment, no triggering factor for its activation is known except smoking.
Active infection results in abnormalities in the architecture of the cervix cells themselves and in that of the tissues.
For this reason, the smear allows them to be detected.
There is a graduation in the severity of the anomalies. When the alterations are significant, they are referred to as “high grade” smears.
A colposcopy will then be required.
Colposcopy
A colposcopy is performed in case of abnormal Pap smears. A colposcopy is a microscope examination performed in a doctor’s practice that lasts about 20 minutes. Dyes will be applied to the collar using cotton.
Colposcopy will allow defining the lesions, mapping them, i. e. drawing them, defining their severity and sometimes taking a sample. This is a biopsy. This gesture is most of the time painless. In this case, there may be minor bleeding for a few days.
In most cases there is no emergency to perform a colposcopy.
Cervix Laser
The laser is a treatment of cervical lesions.
This procedure is recommended in different situations.
First of all, it is the reference treatment of a low-grade lesion of the cervix, i.e. a mild lesion, called until 2017 CIN1. When this lesion persists for more than two years, treatment is recommended. This treatment can be offered earlier if the lesion progresses unfavorably or if follow-up is not possible.
Another indication for cervix laser in absence of a Papilloma Virus lesion is for example a large ectropion.
Conization
A conization is a surgical procedure that consists of removing a portion of the cervix by making a 10 to 15 mm cone.
A conization is performed in case of dysplastic lesions of the cervix, i.e. after performing biopsies during a colposcopy.
The procedure requires anesthesia but does not cause post-operative pain. This is outpatient surgery. Anesthesia may be general or local (referred to as spinal anesthesia) or sometimes sub-local.
The procedure may have to be repeated. Either in immediate postoperative care if the first procedure was incomplete or in the event of a recurrence.
This procedure is not performed during pregnancy nor does it contraindicate it.