Managing HPV: Biopsy Decisions and Vaccination After Diagnosis

Cauliflower (condylomata acuminata) + cervical biopsy

Last year, it was discovered that I had a type 16 HPV infection, and by the end of the year, I had almost recovered and started receiving the quadrivalent vaccine, having received two doses.
However, at the beginning of this year, the warts reappeared.
I had a self-paid Pap smear, and the report indicated an infection with type 6 cells.
The doctor asked if I wanted to proceed with a biopsy or wait for the next Pap smear.
I would like to know if I should show the Pap smear report to a new doctor if I decide to have a biopsy, since the original hospital did not perform the biopsy examination.
Also, since my Pap smear results are already out, do I still need to receive the third dose of the vaccine? If my boyfriend tested negative when I first showed symptoms and we have had safe sex since then, does he need to get tested again? What should I pay attention to if I decide to have a biopsy?

Lin Pangpang, 20~29 year old female. Ask Date: 2017/06/04

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last year, it was discovered that the cauliflower (genital warts) was caused by the HPV type 16 virus.
By the end of the year, it had almost healed, and I started receiving the quadrivalent vaccine, having already received two doses.
However, at the beginning of this year, the cauliflower reappeared.
I had a self-paid Pap smear report done, which indicated an infection with HPV type 6.
The doctor asked if I wanted to proceed with a biopsy or wait for the next Pap smear.
I would like to ask:
1.
If I want to do a biopsy, should I show the Pap smear report to the new doctor?
Answer: Yes, you should.
2.
Since the original hospital did not perform a biopsy, and my Pap smear results are already out, do I still need to receive the third dose of the vaccine?
Answer: Yes, you should get the third dose of the vaccine.
3.
Initially, when I first got sick, my boyfriend's test came back negative.
We have had safe sex during this time; does he need to get tested again?
Answer: It is better for him to get tested again.
4.
What should I pay attention to when undergoing a biopsy?
Answer: Avoid sexual intercourse for 7 days post-procedure.

Reply Date: 2017/06/04

More Info

Managing HPV (Human Papillomavirus) can be a complex process, especially when dealing with the implications of abnormal Pap smear results, potential biopsies, and vaccination. Your situation involves several key components that need to be addressed to ensure proper management of your health.

Firstly, regarding your HPV diagnosis and the presence of genital warts (caused by HPV types 6 and 16), it is important to understand that while the HPV vaccine can help prevent future infections from certain strains of the virus, it does not treat existing infections or warts. Since you have already started the quadrivalent vaccine series, it is crucial to complete all doses as recommended, which typically includes three doses. The vaccine is most effective when given before the onset of sexual activity, but it can still provide benefits even after exposure to HPV.

Now, concerning the biopsy decision, if your doctor has suggested a biopsy after your Pap smear indicated the presence of HPV type 6, it is generally advisable to proceed with the biopsy. This procedure will help determine if there are any precancerous changes in the cervical cells. It is essential to bring your previous Pap smear results to the new healthcare provider, as this information will assist them in making informed decisions regarding your care. The biopsy results will provide clarity on whether any treatment is necessary and what the next steps should be.

If you decide to wait for the next Pap smear instead of proceeding with the biopsy, it is important to discuss this option thoroughly with your healthcare provider. They can help you weigh the risks and benefits of each approach. If there are significant abnormalities or if you have a history of high-grade lesions, a biopsy may be the more prudent choice.

Regarding your boyfriend, if he has not been tested for HPV since your diagnosis, it may be wise for him to undergo testing, especially since he has been diagnosed with a penile lesion associated with HPV. While the vaccine can help protect against certain strains, it does not eliminate the risk of infection from other strains. Open communication about sexual health and testing is vital in managing HPV effectively in both partners.

When preparing for a biopsy, there are a few considerations to keep in mind. Ensure that you discuss any medications you are taking with your healthcare provider, as some may need to be paused before the procedure. Additionally, inform your doctor about any allergies or previous reactions to anesthesia, as this will help them tailor the procedure to your needs. It is also advisable to ask about the recovery process and any potential side effects or complications that may arise from the biopsy.

In summary, managing HPV involves a multi-faceted approach that includes vaccination, regular screenings, and potential biopsies. Completing the vaccine series is important for future protection, while timely biopsies can help address any current health concerns. Open communication with your partner about testing and health status is crucial, and bringing all relevant medical records to your appointments will facilitate better care. Always consult with your healthcare provider to make informed decisions tailored to your specific situation.

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