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SIL (Squamous Intraepithelial Lesion)

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Last Modified: February 2, 2003

Dear OncoLink "Ask The Experts,"
I am 32 years old and have been having pelvic pain and fullness, pain with intercourse, spotting throughout the month and white discharge, all of these for the past 2 years, worsening in the last 6 months. I chalked this up to female annoyances until my last pap came back with low grade SIL (Squamous Intraepithelial Lesion). This is my first pap in 3 years since the previous ones were negative. What do you recommend in the way of testing? Is this something I need to be concerned about?  

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

The low grade SIL (Squamous Intraepithelial Lesion) on your Pap test needs to be followed up with a repeat Pap in 4 to 6 months. Persistent abnormalities may warrant colposcopically directed cervical biopsies. Often, low grade SIL resolves on its own without any additional intervention, but close follow-up is recommended to make sure it does not progress to a high-grade lesion.

I think you should discuss your other symptoms with your health care provider. Symptoms of painful intercourse, pelvic pain and irregular bleeding persisting for 2 years should be investigated. I think that your symptoms are unlikely to be related to the low grade SIL detected on your Pap test. Many different things may cause your symptoms, but some possible gynecologic causes include endometriosis and ovarian cysts.