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Cervical Irritation
July 2000

Q. I am a female who has been experiencing lower middle abdominal pain, abdominal swelling and heaviness as well, for a little over two weeks now. I had a pelvic exam and pap smear approximately 2-1/2 months ago, where the doctor stated my cervix looked irritated and prescribed Flagyl. I went to another doctor, and she diagnosed me with a UTI. She requested no urine sample, she did not touch me, and I've had no problems with urination, except that I have been urinating more frequently. She gave me a prescription for an antibiotic and said to call the office in the event the infection did not clear up. Can you suggest a method I have not taken?

A. Trying to piece together your case, it sounds like you probably have mild cervical dysplasia. This occurs when the cervical lining gets inflamed and the cells undergo some degree of pre-cancerous changes. Viral infections such as human papilloma virus, which may be sexually transmitted is a common cause. If very mild, it is possible to simply repeat periodic pap smears to make sure there is no progression. If more moderate to severe, usually it is further evaluated with colposcopy and biopsy. It may then be treated with a variety of methods including laser treatment. The prognosis is usually good.

However, cervical dysplasia is usually asymptomatic (ie. no symptoms such as pain). Therefore, in your case, I suspect that you have another cause for your abdominal pain. Endometriosis and urinary tract infections are one of several possibilities. Further lab tests and possibly and abdominal/pelvic ultrasound may be useful. I suggest that you follow up with whomever you have the greatest confidence in for re-evaluation.

Good Luck.

Ref: http://www.4woman.gov/search/Doclist.CFM?start_r=1

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