الفهرس | Only 14 pages are availabe for public view |
Abstract See and treat policy (LEEP at the first colposcopic visit) is a cost effective, practical and fast method of treating most cervical lesions with limited complications and has the advantage of eliminating a second session of treatment. These advantages, particularly important in developing countries. This work was performed to study the diagnostic and therapeutic efficacy of see & treat policy in management of the colposcopic findings suggestive ofCIN. Out of 315 non pregnant women having clinically suspicious cervix on speculum examination, fourty patient were found to have ATZ by colposcopy. For every patient cytology and LEEP were performed in the same sitting. The cytological finding showed 3 cases (7.5%) normal smear, 7 cases (17.5%) inflammatory smear, LG-SIL in 19 cases (47.5%) and HG-SIL 11 (27%). False negative cytology was found in (20%). Cytology revealed sensitivity of (78.37%), specificity of cytology (66.6%) and accuracy (80%). Colposcopic findings revealed 16 cases (40%) of LG-SIL and 24 cases (60%) of HG-SIL. False positive rate of colposcopy was 3 cases (7.5%). Similar diagnosis of LG-SIL was found in (68.75%) and 70.8% of HG-SIL. The over treatment rate of see and treat policy was (7.5%).The over treatment rate of see and treat policy was 12.5% in cases of LG-SIL and 4.1% in cases of HG-SIL. Histopathological findings revealed that 3 cases (7.5%) of non specific cervicitis, 16 cases (40%) of LG-SIL and 21 cases (52.5%) of HG-SIL. There was significant correlation between cytology, colposcopy and histopathology. Persistence of the lesion after LEEP was found in 2 cases out of 34(5.7%).Three patients were lost to follow up(8.1%)There was no significant correlation between age, parity or the degree of the lesion and the failure of LEEP. However involvement of the margin had a very strong predictive value for failure ofLEEP. Postoperative complications in the fom of vaginal spotting (12.5%), vaginal discharge (30%) and menorrhagia (2.5%). 1- See and treat policy is associated with over treatment rate of 7.5%. 2- The complication ofLEEP are minimal and well tolerated. 3- The failure rate ofLEEP is 5.7%. 4- Failure ofLEEP is not dependent on age, parity, or grade of the lesion but on involvement of the margin. |