Cervical Ectropion and Intra-Uterine Contraceptive Device (IUCD): a five-year retrospective study of family planning clients of a tertiary health institution in Lagos Nigeria

Abstract

BackgroundCervical ectropion (also known as cervical erosion) is a common finding on routine pelvic examination during the fertile years. The decision to treat or not remains controversial. According to studies in support of routine treatment of cervical erosion, there is a possible relationship between squamous metaplasia and squamous cell carcinoma of the cervix. To determine the prevalence of cervical ectropion and associated risk factors among clients with intra-uterine contraceptive devices (IUCDs) attending a family planning clinic of a tertiary health institution in Lagos, Nigeria.MethodsA 5-year retrospective study was conducted by assessing existing clinic records from years 2007–2011. Clients with IUCDs undergo routine pelvic examination during check-up visits. A total of 628 clients’ records were seen within the stated time frame. This study was approved by the ethical committee of the Lagos State University Teaching Hospital (LASUTH) and the collected data were analyzed using SPSS version 19.0.ResultsThe mean age of the IUCD users was 34.7 ± 6.52 years, while 517 (82.3%) had secondary education. On routine pelvic examination, seventy-nine clients (12.6%) had cervical ectropion. Thirty-nine (6.2%) clients had presented with a history of abnormal vaginal bleeding while 12.1% had vaginal discharge. Treatments offered to cases of cervical ectropion include cervical painting with gentian violet (89.9%) and antibiotics prescription (58.2%). On bivariate analysis, previous hormonal contraceptive use (P = 0.041) and vaginal discharge (P < 0.001) were significantly associated with developing cervical ectropion. Clients with ectropion were significantly more likely to receive prescriptions for antibiotics (P < 0.001).ConclusionLess than one fifth of the clients had cervical erosion. However, routine pelvic examination could aid the detection and control of latent reproductive health problems such as cervical ectropion which may require further investigations for example, pap smears, to exclude potentially lethal conditions and to determine appropriate treatment modality.

Real‑world study of Cerviron® vaginal ovules in the treatment of cervical lesions of various etiologies

“…Moreover, cervical erosions can be of traumatic, mechanical etiology, such as intrauterine devices or foreign bodies introduced into the vagina ( 2 ). Its prevalence ranges from 17 to 50% ( 3 , 4 ). The presence of ectropion is detected especially after the menarche, during pregnancy or with use of the combined oral contraceptive pill and is very rare in postmenopausal women ( 5 ).…”

Accuracy of visual inspection with acetic acid in cervical ectopy evaluation

“…The use of IUDs may be associated with cervical trauma and inflammation which could lead to cervical ectopy, cervical dysplasia and even cervical malignancy. These findings were in disagreement with Wright et al (2014) [4] study about "cervical ectropion and intra-uterine contraceptive device (IUCD): a five-year retrospective study of family planning clients of a tertiary health institution in Lagos Nigeria", in which only about one tenth of the study subjects had cervical ectopy despite the fact that all of them used an IUD.…”

“…A prevalence study in China among female users of family planning services reported that 43.2% of women had cervical ectopy. [4] Another study on women using OCPs and IUCDs in Benghazi, Libya also observed that cervical ectopy was the commonest gynecological disorder among the women (54.9%). [5] Ectopy is rare beyond the menopause and frequent at reproductive ages.…”

Comparing some screening values of Pap test and visual inspection with acetic acid in the diagnosis of precancerous cervical lesions (2016-2017)

“…In our study, the false positive rate of VIA was 2.0%, which is considerably lower than the rates reported in similar studies (21,22). Perhaps the reason for the conflict of results is the young research community, because in young people, ectropion and metaplasia are more common (23). The study of Ardahan et al in Turkey reported 82.14% sensitivity and 50% specificity for VIA, and suggested that VIA can serve as the method of choice for cervical malignancy screening (11).…”