The paper describes the technique of 'LLETZ' (large loop excision of the transformation zone), a new method of management for women with an abnormal cervical smear which offers the advantages of conization with those of local destruction. A large loop of thin wire forms a diathermy electrode that allows deep excision of the transformation zone with minimal tissue damage. The tissue removed can be examined histologically. The technique was used to investigate and treat 111 women with abnortnal sinears referred to the Bristol Royal Infirmary during 1986, Microinvasive disease was rcvcalcd in onc woman where it was not suspected by cytology or colposcopic examination. Of 102 women followed up for at least 1 year by cytology, colposcopy and, where appropriate, histology, two women were found to have residual/recurrent cervical intraepithelial neoplasia.Women with a dyskaryotic smear should have a colposcopic examination (Jordan et a / . 1982). Subsequently the transformation zone in women with cervical intraepithelial neoplasia (CIN) may be managed either by excision or by dcstruction. Traditionally excision has been equated with cone hiopsy (or rarely hystcrcctomy). Cone biopsy achicvcs complete removal of thc transformation zone and the dysplastic tissue within it. This has the distinct advantage over destructive techniques in that the specimen may be examined histologically; microinvasivei invasive disease can be excluded with confidence 6008 95, 1206-1208. S~r g 1, 276-281. 86, 913-916. GyFlueCOl 93, 773.776. ,4171 58, 97-108. -.. vix-an enigma of diagnosis. Br J Obstet Gynaecol 91, 1150-1160. Claman A. D. Xr Lee N. (1074) Factors that relate t o

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Summary These guidelines for the management of vulvodynia have been prepared by the British Society for the Study of Vulval Diseases Guideline Group. They present evidence‐based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines.

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We report a case of hemoperitoneum in pregnancy that resulted from spontaneous rupture of the uterine vessels associated with decidualized endometriosis.