Reactive Changes, Reparative Changes, and Repair

Repair
Repair

Changes in the skin cells of the cervix which suggest that a healing process is underway or that the cervix is reacting to the presence of a virus or bacteria.

While these changes are not dangerous, their presence often provokes gynecologists to repeat the Pap smear at a sooner-than-expected time (such as 6 months, rather than 1 year after the previous Pap). The reasons for this increased surveillance are:

Reactive or Reparative changes make the Pap more difficult to interpret, so that the clinician cannot be as reassured by this Pap as he/she would by a Pap without these changes, and

Distinguishing between reactive/reparative changes and early dysplasia is difficult and the Pap interpretation may be incorrect.

Other gynecologists feel that in a patient with previously normal Pap smears, the first appearance of reactive/reparative changes is not cause for alarm and they will repeat the Pap at the next annual examination. They reason that should there be an underlying dysplastic process, the progression of Dysplasia is usually so slow that there is no particular advantage to repeating the smear sooner than the annual exam.

Women's Healthcare in Operational Settings