How do you treat an ovarian cyst?

Most simple cysts are just small fluid containing pockets in the ovary and given enough time, usually a few weeks, will disappear.  So usually we can wait and allow the body to heal the ovary on its own.

You can take NSAID pain meds such as Aleve, or Ibuprofen, and sometimes a pain medication with a narcotic.  Estrogen and progesterone pills, oral contraceptive pills, also can help speed the disappearance of a simple cyst.

A sonogram is useful to check on the cyst and make sure it is getting smaller or to make sure it has completely vanished.

Occasionally because the cyst is getting larger, or not disappearing, surgery may be required to remove the cyst and repair the ovary.  The doctor usually will insert a lighted tube, a laparoscope through the belly button to get a close-up look at the problem.  The doctor may be able to repair the ovary through 2 or 3 band-aid size small incisions in the abdomen.  It may be necessary to make a larger incision to go in and treat the problem.

If the cyst has debris or solid parts as well, the doctor may recommend surgery to remove it and send the specimen to the laboratory to be checked for any abnormal type of growth.

When should I get a pap test? How often?

There are new recommendations for pap tests from the American Cancer Society (ACS) and the American Congress of Obstetricians and Gynecologists (ACOG.)  It is now suggested that most young women have the first pap test at age 21 years.  The research shows that the young woman’s immune system will clear any of the viruses that lead to cervical cancer prior to this age.  If her pap test is negative, the American Cancer Society says that a woman can wait and do the cancer screening test every 2 years.  If a woman is 30 and has had 3 negative or normal pap screening tests in a row, ACS and ACOG believe she could even do the cancer screening test every 3 years.

Of course, some women have expressed the concern that they do not want to wait 2 to 3 years to find out if they have a problem and would rather get the pap test every year when they come in for their annual well woman check-up.

If the pap test is in that gray area, normal but signs of a high risk HPV virus, the woman should definitely have a repeat pap in at least one year if not in 6 months.

 

If there is an abnormal pap test or a pap test that says atypia and high risk HPV, the next step is to look at the area with a colposcope.  The colposcope is a just a microscope on a stand.

The doctor will look through the colposcope at the cervix after wiping off the mucus present.  If there is anything suspicious, she will take a tiny pinch of that area to send to the lab.  She’ll finish by gently scraping a few loose cells just inside the cervix to send to the lab as well.

Once the results of the biopsies come back the doctor will recommend treatment.

If there are just mild changes or just atypia, she’ll recommend repeat pap tests every few months to watch the cervix clear the changes from the virus and to make sure the problem does not go any further.

If there are any pre-cancerous changes she will suggest numbing the cervix and scraping off the abnormal outer layer.

Pre-cancerous changes of the cervix can also be treated by freezing the outer layers of the cervix.

Any more advanced abnormality of the cervix is treated with surgery and/or radiation therapy.

 

What does it mean when my pap test shows HPV?  What’s the difference between an abnormal pap and HPV?

Part 1

The Pap test has been used since the early twentieth century to look for cancer of the cervix.  Over the years the original test has been refined and now this test looks for cancer of the cervix, pre-cancer of the cervix and sexually transmitted diseases.

HPV or human papilloma virus is a common virus that the Pap test can pick up.  There are about 100 different HPVs. The low risk virus group causes the warts sometimes seen on the outside of the genitals.  The high risk virus group can lead to pre-cancer and later, if not treated, cancer.

Research guesses that 80% of the general sexually active population in the United States carries at least one of these viruses.  That would include, moms and dads, and grandparents who of course are moms and dads and grandparents because at some time they were sexually active.

The Pap test is normal if there is no sign of pre-cancer –dysplasia, and no signs of cancer.

An abnormal pap test may have dysplasia, cancer, or neither and just say atypia.  Atypia just means “look a little closer, there may be something there.”