Care · By concern

HPV, abnormal smear and colposcopy: screening, monitoring and treatment at the practice, in Paris 16th

An abnormal smear test or a positive HPV test is always worrying; in the great majority of cases it is not cancer, but an abnormality that needs a closer look. At the practice, 42 avenue Mozart, Dr Chaima Gatri, OB-GYN and gynecological (gynaecological) surgeon, performs colposcopy, biopsy and laser treatment of cervical lesions during the consultation; conisation, when it is needed, is carried out at the Clinique de la Muette, a five-minute walk away. English-speaking practice.

Recognizing it

An abnormal smear, a positive HPV test: what it means

Human papillomavirus (HPV) is a very common virus, passed on through contact during intercourse: most women encounter it, and most infections clear on their own. In some women the virus persists and causes precancerous lesions of the cervix, which are slow to develop and which screening exists to detect and treat in time.

An abnormal result is the starting point of an assessment and of monitoring tailored to your situation. HPV vaccination is recommended for teenage girls and boys: the physician prescribes it, the pharmacist administers it.

Book an appointment — Dr GATRI

Assessment

Colposcopy at the practice, during the consultation

Colposcopy is the examination of the cervix under magnification, after applying solutions that make abnormal areas visible. The practice is equipped with the DYSIS Ultra digital colposcope, which assists Dr Gatri with real-time mapping of the cervix and keeps visual documentation of the examination (equipment). The examination takes place during the consultation, like a smear test; if a biopsy is needed — a sample of a few millimeters —, it is taken at the same time. You leave with the printed report of the examination.

The biopsy result determines the next step — monitoring, laser at the practice or conisation —, which Dr Gatri explains to you. The screening smear test and the HPV test, for their part, are performed during a gynecology consultation with Dr Gatri or Dr Mahdhi-Basli (the team; see Medical gynecology).

Treatments

Monitor, treat with laser, operate: the steps

  1. Monitoring — for low-grade lesions and HPV infections without a lesion, which most often regress on their own: smear test, HPV test and colposcopy at regular intervals, according to current guidelines.
  2. Laser vaporization at the practice — for precancerous cervical lesions suited to it: Dr Gatri destroys them by laser vaporization, under colposcopic guidance, without a hospital stay. A follow-up consultation checks healing and organizes surveillance (Fotona laser).
  3. Laser treatment of genital warts — warts of the vulva are treated at the practice by vaporization with the Fotona laser; the number of sessions depends on the extent of the lesions. A quotation is provided at the prior consultation.
  4. Conisation at the Clinique de la Muette — when the lesion requires it, Dr Gatri removes a cone-shaped fragment of the cervix, generally as day surgery; it is analyzed in full, then regular smear-test surveillance follows. The pathway is described on the Surgery page.

The information sheets of the French College of Gynecologists and Obstetricians (CNGOF), translated into English, are given to you at the consultation: cervical screening smear test and cervical conisation.

Frequently asked questions

Your questions, our answers

I am HPV positive — should I worry?

Not in the sense of an emergency. HPV is very common and, most of the time, the body clears it on its own. A positive test means the cervix needs a closer look and monitoring over time: it is the persistence of the virus that leads to lesions.

Does colposcopy hurt?

The examination is like a slightly longer smear test: the speculum stays in place for a few minutes and the solutions sometimes sting. It is generally well tolerated. The biopsy causes a brief pinch; light bleeding over the following days is usual.

Do all lesions need treatment?

No. Low-grade lesions most often regress on their own: we monitor them. High-grade lesions are treated — laser at the practice or conisation — because, over the years, they expose you to cervical cancer.

Laser or conisation?

Laser destroys the lesion without removing tissue; it suits lesions that are fully visible at colposcopy. Conisation removes the lesion and allows it to be analyzed in full; it is chosen when the lesion extends into the cervical canal or when complete analysis of the tissue is needed. The choice is made with you, based on the images and the biopsy.

Can I still have children after a conisation?

Conisation preserves the uterus: pregnancy remains possible. Because the cervix is shortened, a subsequent pregnancy is monitored more closely. This point is discussed with you before the procedure, according to your plans, and the College's information sheet covers it in detail.

Should my partner be examined?

HPV circulates very widely: within a couple, both partners have most often shared it. There is no routine HPV screening for men; visible genital warts, on the other hand, should be shown to a doctor. Raise it at the consultation.

Is it covered by health insurance?

Consultation, smear test, HPV test, colposcopy, biopsy and conisation are covered by the French health insurance (Assurance maladie) under the usual sector 2 conditions. For laser procedures, coverage depends on the indication; the quotation given at the consultation specifies it for your case. The full picture is in “Fees and reimbursement”, further down.

How do I book?

On Doctolib, with Dr Gatri: “Colposcopie” for an abnormal smear or a positive HPV test, “Consultation avec frottis” for screening, “Consultation pour conisation du col” when conisation has been proposed; laser sessions are scheduled afterwards. Or by telephone through the secretariat.

Fees

Fees and reimbursement

The consultation, smear test, HPV test, colposcopy, biopsy and conisation are covered by the Assurance maladie under sector 2 (non-OPTAM) conditions; for laser procedures — cervical lesions, genital warts — coverage depends on the indication: some are covered by the Assurance maladie, the others are outside the official schedule and are not reimbursed; a quotation is provided before any laser treatment and specifies it for your case. Fees are listed in the fee schedule and displayed at the practice. The information framework of this site is described on the Patient information and ethics page.

Appointments

Book an appointment

Appointments can be booked online via Doctolib or by telephone through the secretariat.

Doctolib — Dr Chaima GATRI