Is Cryotherapy Friend or Foe for Symptomatic Cervical Ectopy?

Çekmez, Yasemin; Şanlıkan, Fatih; Göçmen, Ahmet; A, Vural; Türkmen, Simge Bagcı

doi:10.1159/000441433

Cited by 17 publications

(34 citation statements)

References 14 publications

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“…A similar connection was noted in other studies [18]. The proportion of women with high parity (2 and more labors per vias naturalis) in group 1 and group 2 was three times higher (p<0.05), than in group 3, which can be explained by the probable relationship between obstetric trauma and CE in this contingent of patients [19].…”

Section: Discussionsupporting

confidence: 87%

“…The frequent presence of cervicitis cytological indicators in patients with firstly diagnosed and recurrent CE correlates with the results of other studies: Singh et al [21], studying the etiology of inflammatory cervical smears, found CE in a significant proportion of patients; moreover, the presence of CE can be associated with recurrent cervicitis [19].…”

Section: Medicine and Dentistrysupporting

confidence: 85%

“…This fact should be taken into account when choosing the treatment method for complicated CE, as it has been established that, in particular, cryodestruction of CE in patients with ≥3 episodes of cervicitis exacerbation during the past 6 months was 9 times less effective [19].…”

Section: Medicine and Dentistrymentioning

confidence: 99%

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Analysis of Complicated Cervical Ectopy Clinical Course and Recurrence

Mazur

Pyrohova

2018

EUREKA: Health Sciences

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Physiological cervical ectopy (CE) is commonly found in young women, during pregnancy or intake of oral contraceptives. The complicated (pathological) CE, particularly in conditions of vaginal microbiota disturbances and human papillomavirus (HPV) infection, requires intervention, including optimal treatment and effective relapse prevention approaches. Aim. The aim of the research was to investigate the complicated CE clinical course and recurrence features on the basis of a retrospective analysis of archival medical records in order to optimize the tactics of the complicated CE management and the relapse prevention measures. Materials and methods. In the observational cross-sectional retrospective study using the continuous sampling method were included 740 case reports of women, who underwent inpatient treatment of gynecological pathology in Lviv Municipal Clinical First Aid Hospital in 2006–2017. The inclusion criterion was the presence of firstly diagnosed or recurrent CE. Exclusion criteria: absence of CE colposcopic or morphological confirmation, presence of physiological CE (on conditions of cytological, bacterioscopical, bacteriological and colposcopical abnormalities absence). Subsequently, three groups were formed: control group (n=150) – healthy women, who applied for a regular gynecological examination; group 1 (n=483) – women with firstly diagnosed CE; group 2 (n=257) – women with recurrent CE. Differences in mean values were considered significant with a probability level of at least 95 % (p<0.05). Results. Patients with recurrent CE had more pregnancies (p<0.05) than the ones with firstly diagnosed CE and women of control group. The proportion of women with high parity in group 1 and group 2 was three times higher (p<0.05), than in group 3. The proportion of artificial abortions in patients of groups 1 and 2 was more than two times higher (p<0.05), than in women in the control group, group 2 patients had more miscarriages and missed miscarriages(p<0.05) in comparison to the control group. Menarche in patients with recurrent CE set in later in comparison to women of control group (p<0.05). In group 2, the proportion of women with polymenorrhea was three times higher (p<0.05), than in group 1 and control group respectively. The compromised gynecological history was more often (p<0.05) detected in group 1 and group 2, than in the control group. In patients with recurrent CE a third of gynecologic diseases in the history (32.30±2.92 %) and 23.60±1.93 % - in patients with the firstly diagnosed CE were pelvic inflammatory diseases, significantly (p<0.05) higher in comparison to the control group (3.33±1.47 %). Almost half of patients in group 1 (48.25±2.27 %) and group 2 (47.84±3.13 %) had the history of frequent infectious diseases, this indicator was significantly (p<0.05) higher in comparison to the control group (24.67±3.52 %). In patients with recurrent CE chronic diseases of different etiology were diagnosed more often (p<0.05) - their share made up 8.24±1.72 %, while in patients with firstly diagnosed CE - 4.33±0.92 %, in women of the control group - 1.33±0.94 %.The firstly diagnosed CE was more frequent (in comparison to recurrent CE) (p<0.001) characterized by asymptomatic course, whereas about half of patients with recurrent CE (46.69±3.11 %) presented with different complaints. Cytological indicators of cervicitis were found more often in patients with firstly diagnosed and recurrent CE, than in women of control group, as well as vaginal candidosis (p<0.05). Patients with recurrent CE more often (p<0.05) underwent diathermoconization (24.12±2.67 %) and cryodestruction of the cervix (8.17±1.71 %) in comparison to patients of group 1. The most often performed treatment method in patients of both groups was diathermoconization. Treatment methods aimed to restore the hormonal balance, to normalize the state of vaginal microbiota were rarely found in both group 1 and 2, drugs that affect the reparation and regeneration of the epithelium have not been used in any case. Conclusions. Recurrent symptomatic complicated CE should be interpreted as a complex problem that requires a multi-polar approach aimed at hormonal homeostasis, local immunity, and vaginal biocenosis normalizing. These measures should precede invasive treatment and further create optimal conditions for regeneration of the cervix.

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Section: Discussionsupporting

confidence: 87%

Section: Medicine and Dentistrysupporting

confidence: 85%

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Analysis of Complicated Cervical Ectopy Clinical Course and Recurrence

Mazur

Pyrohova

2018

EUREKA: Health Sciences

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“…6 Spontaneous thawing occurred within 60 seconds of the cessation of freezing. An additional freeze-thaw cycle was performed.…”

Section: Case Reportmentioning

confidence: 99%

046 Cervical Ectropion may be a Cause of Desquamative Inflammatory Vaginitis

Mitchell

King

Brillhart

et al. 2017

The Journal of Sexual Medicine

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Desquamative inflammatory vaginitis is a poorly understood chronic vaginitis with an unknown etiology. Symptoms of desquamative inflammatory vaginitis include copious yellowish discharge, vulvovaginal discomfort, and dyspareunia. Cervical ectropion, the presence of glandular columnar cells on the ectocervix, has not been reported as a cause of desquamative inflammatory vaginitis. Although cervical ectropion can be a normal clinical finding, it has been reported to cause leukorrhea, metrorrhagia, dyspareunia, and vulvovaginal irritation. Patients with cervical ectropion and desquamative inflammatory vaginitis are frequently misdiagnosed with candidiasis or bacterial vaginosis and repeatedly treated without resolution of symptoms. We report the case of a 34-year-old woman with a 4-year history of profuse yellowish discharge and dyspareunia. Upon presentation, her symptoms and laboratory results met the criteria for desquamative inflammatory vaginitis, but the standard treatments did not provide long-lasting relief. As a last resort, cryotherapy (cryosurgery) of her cervix was performed for treatment of her cervical ectropion, which provided complete resolution of her symptoms. Mitchell L, King M, Brillhart H, Goldstein A. Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis. Sex Med 2017;5:e212ee214.

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“… 5 The presence of the metaplastic columnar epithelium can manifest a myriad of symptoms including increased vaginal discharge, leukorrhea, postcoital bleeding, pelvic pain, recurrent cervicitis, and dyspareunia. 5 , 6 , 7 , 8 Although the symptoms of ectropion overlap with DIV, it has not been reported as a cause of DIV.…”

Section: Introductionmentioning

confidence: 99%

Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis

et al. 2017

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Desquamative inflammatory vaginitis is a poorly understood chronic vaginitis with an unknown etiology. Symptoms of desquamative inflammatory vaginitis include copious yellowish discharge, vulvovaginal discomfort, and dyspareunia. Cervical ectropion, the presence of glandular columnar cells on the ectocervix, has not been reported as a cause of desquamative inflammatory vaginitis. Although cervical ectropion can be a normal clinical finding, it has been reported to cause leukorrhea, metrorrhagia, dyspareunia, and vulvovaginal irritation. Patients with cervical ectropion and desquamative inflammatory vaginitis are frequently misdiagnosed with candidiasis or bacterial vaginosis and repeatedly treated without resolution of symptoms. We report the case of a 34-year-old woman with a 4-year history of profuse yellowish discharge and dyspareunia. Upon presentation, her symptoms and laboratory results met the criteria for desquamative inflammatory vaginitis, but the standard treatments did not provide long-lasting relief. As a last resort, cryotherapy (cryosurgery) of her cervix was performed for treatment of her cervical ectropion, which provided complete resolution of her symptoms.Mitchell L, King M, Brillhart H, Goldstein A. Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis. Sex Med 2017;5:e212–e214.

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Is Cryotherapy Friend or Foe for Symptomatic Cervical Ectopy?

Cited by 17 publications

References 14 publications

Analysis of Complicated Cervical Ectopy Clinical Course and Recurrence

Analysis of Complicated Cervical Ectopy Clinical Course and Recurrence

046 Cervical Ectropion may be a Cause of Desquamative Inflammatory Vaginitis

Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis

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