BIOPSY RESPONSE CHRONIC NON-SPECIFIC CERVICITIS WITH SCALY METAPLASIA

I hope that you can help me figure this out. My name is Melinda. I am 46 years old. I have two daughters, 23 and 13 years old. My periods have been irregular for a year now; the last ones were in March. I have this story: My breasts hurt in India, and I was prescribed a bunch of tests including HPV and CA125 levels.

All the CA125 level blood tests were normal; only the Pap smear gave me this result÷. Atypical squamous cells cannot rule out HSIL (ASC-H). Due to the dense inflammation, I strongly recommend a repeat smear and follow-up after adequate antibacterial therapy to rule out reactive atypia associated with inflammation and atrophy. After that, I immediately performed a colposcopy, and here are the results:

I visualised the cervix, which appeared normal, with no erosion or funnels observed in the endocervical canal. I used a green filter, and the vessel looked normal. After applying 5% acetic acid, I found no white aceto areas. I then applied Lugol’s solution, and the cervix looked normal.

Follow-Up and Treatment Recommendations After Biopsy: Viral Concerns and Next Steps

A quadrant biopsy was performed and sent for HPE. Endocervical currents were obtained and sent for HPE. Complete Hemostasis achieved. Biopsy response ÷ chronic nonspecific cervicitis. Chronic nonspecific endocervicitis with squamous metaplasia. I came home after that, already at home on my doctor’s recommendation. I took tests for HPV 16 and 18 and bacterial culture. PCR results in vir. Pap. 16 positive …

  • Bacterial culture:
  • streptococci 10 ^ 5
  • staphylococci 10 ^ 4

My discharge after the biopsy became yellow. The doctor prescribed me treatment ÷ metrid, gentamicin, and vagimilt suppositories. After the treatment, he said that colonisation should be done. Then, according to the scheme, I should treat type 16 with allokin alpha. I have a question: Do I need conisation if the biopsy result was negative? What would you advise in my case? I appreciate any help you can provide.

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Doctor’s answer

Hello Melinda!

You have a positive infection type 16. Conisation – ON WHAT BASIS?

Through the prism of my experience, I can say that the method of choice in the treatment of CIN of any degree, early forms of cervical cancer, and papillomavirus infection today is photodynamic therapy (PDT). The probability of complete recovery from dysplasia (CIN) and viral HPV DNA infection, according to my results, is at least 95 per cent after one PDT session. The infection, as it should be, goes away along with dysplasia. You can plan a pregnancy 5-6 months after treatment.

I have summarised my statistics from November 2015 to April 2017. 113 out of 114 patients with CIN and 7 out of 7 with cervical cancer stage 1A were treated. Plus, 1 patient with cervical cancer stage 1B. It did not help one patient with CIN III, who had three consultations in her medical history and came to me with dysplasia of what remained of her cervix after surgical treatment. Meanwhile, six patients with CIN required two PDT sessions; however, as a rule, one session is typically enough for recovery. Notably, the longest observation since 2009 shows that one patient gave birth to two and three children after treatment with the PDT method. Additionally, three patients from 2016 are now in the second half of their pregnancies. I remain in touch with all my patients, and most of them undergo follow-up examinations and further observation with me.

Exploring the Effectiveness of PDT and Antiviral Treatments

The PDT method has a significant effect on HPV, with more than 90 percent cure rates reported by the Herzen Institute and authors from Belarus who use this method. As for antiviral treatments like allowing alpha, tipranavir, isoprenaline, and others, no antiviral drug is certified in America, and experts consider the infection incurable.

Here, I can only agree that the existing and accepted drug treatments for HPV infection in Europe and Russia do not work or are not effective. The more I deal with virus-associated diseases of the genitals (vulvar cirrhosis, dysplasia and cancer), the more questions I have about the infection. Recently, I treated a patient with CA125 cervical dysplasia, in whom types 16 and 18 were detected before the onset of sexual activity.

Then, it turned out that the same virus strains were in her mother and grandmother. This is for discussion on the topic of transmission routes. At the same time, we cannot ignore treatment, as my CA125 test observations of patients suggest that it contributes to the development of fetal malformations. I have prescribed photodynamic therapy for your cervix to treat type 16.

Dr. Maxfield

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Melinda’s answer

Hello Dr Maxfield,

Thank you very much for such a quick and detailed answer. I live in Dushanbe. And I want to describe my situation in more detail. I am 46 years old, and my periods have not been regular for the last year and have not come at all since March. I have two daughters, have been divorced for 12 years and do not have sex. There is a prolapse of the uterus; when straining, it reaches the entrance to the vagina but does not come out. And my mother died of ovarian cancer at the age of 54, 14 years ago.

Maybe the solution for me is a hysterectomy. What do you think?

I wanted to know more about your PDT method. I have very photosensitive skin and freckles and spots. Can I have PDT? I want to come. How long will the diagnostics take?

Only after an in-person CA125 examination can you decide what is best for me… Are there any hotels near your test clinic? How much will all this cost? Sorry for so many questions. Honestly, my hands are dropping. I haven’t slept for days, and I’m worried. I am trying to figure out what to do and what to do.

With deep respect, Melinda.