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SQUAMOUS METAPLASTIC CELLS in PAP smear. Is HYSTERECTOMY needed?

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My wife 44 yrs Pap smear report shows few squamous metaplastic cells and it diagnised negative for intraepithelial lesion or malignancy. Her USG Pelvis (TVS) shows tiny nabothian cysts in cervix. She has vaginal itching, sometimes whitish discharge from the vagina, irregular menstruation, feeling of tiredness, sweat smells bad. But no burning while urinating, No spotting and pain after intercourse. Blood and ECG report is normal.fluconazole side effect shows a red rash on the forefinger.
Is she a hysterectomy necessary? Frequent itchines made her unwell. Clotrimazole Vaginal Suppositor experience relief for sometime from itching. Burning sensation when she apply Lobate-GM. Please advise.

Category: OBGYN

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Category: Infertility Specialist
 30 Doctors Online

Hello,
Thanks for posting your query at DoctorSpring.com
I can see no reason for a hysterectomy.
Irregular menstruation is common at the age of 44, as this is perimenopausal.
Tiredness etc is also quite common.
She should get the following workup -
1. Colposcopy for the cervix.
2. Vaginal swab for diagnosing vaginal infection.
3. Thyroid and blood sugar levels.
She should be treated for the itching according to the culture and swab.
Drink lots of water.
For irregular periods, cyclical progesterone therapy can be started.
All the best
Please feel free to discuss further.
Regards.


Patient replied :

Thank you very much Doctor. As you advice she will undergo for Colposcopy and Vaginal swab test. But Doctor she was quite gud relief from vaginal itching with fluconazole tablets. But the problem is it react itching so severely on the finger with red rash. Doctor why this reaction occurs? Is there any alternative med? Is there any chance of cancer development in future? I am afraid. plz help.


Hello,
Since she had side effects to fluconazole, she should not take it again.
The alternative medications can be decided based on the vaginal swab result, you can upload that to me.
Also, there is no risk of cancer, as all her reports are normal.
Relax, and dont worry.
Regards.


Patient replied :

Doctor, these are tests I have done last week. For your kind response I have uploaded all the reports.


Hello.
Thank you for the reports.

All these reports are quite normal.
There is no reason whatsoever for a hysterectomy at all.

Take care.


Patient replied :

Thank you Doctor. But she has had a sore/geographical like tongue for the past 6 years. It comes and goes. It becomes worst when she use hot and spicy or extremely acidic foods. I have uploaded a picture of her tongue.
Doctor is there any relation with her vaginal itchiness and her tongue infection.
Please suggest me and give some medication for her vaginal itchiness.


Geographical or sore tongue commonly occurs in reaction to spicy and irritant foods, it is best to avoid it.
Also, taking a multivitamin capsule such as Cap. A to Z will help.
Maintaining good oral hygiene is amust.
There is no corelation between vaginal itching and geographical tongue.
I cannot presribe any medication without a vaginal swab, as only that will confirm the type of infection.
Regards.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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