K Yang1, J Li, Y Liu, B Ma, H Roberts, J Tan, J Tian, T Wu, P Zhang. 1. LanZhou University, Centre of Evidence Based Medicine of LanZhou University, No.103 Dong Gang West-Road, Lanzhou, Gansu, China, 730000. yangkh@lzu.edu.cn
Abstract
BACKGROUND: Cervical ectropion is considered as one of the most common types of chronic cervicitis in China. Topical treatments for cervical ectropion including microwave tissue coagulation, are widely used in many hospitals in China. Nowadays, the necessary intervention for inflammatory cervical ectopy is controversial. OBJECTIVES: To compare the efficacy and potential side effects of microwave tissue coagulation with other interventions or no intervention in the treatment of cervical ectropion. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2006, Issue 1), MEDLINE (1966 to 2005), EMBASE (1974 to 2005); The Chinese Biomedical Database (CBM, 1978 to 2005), The Chinese Medical Current Contents (CMCC, 1994 to 2005), CAJ Full-text Database (1994 to 2005) and Chinese Scientific Journals Database (1989 to 2005). We also searched related literature on the Internet with search engines such as Google, searched the reference lists of articles and hand searched relevant Chinese journals. SELECTION CRITERIA: Only authentic randomized controlled trials (RCTs) were included. DATA COLLECTION AND ANALYSIS: Two authors independently interviewed the original authors of claimed RCTs published in China and then assessed the quality of the three included RCTs and extracted data. MAIN RESULTS: No studies were found that met the participant inclusion criteria of the protocol. Although three studies were identified as authentic RCTs from 92 potential RCTs, it was not possible to confirm that the participants were symptomatic prior to treatment. Of these three studies two trials compared microwave therapy with laser and one compared microwave therapy with interferon-alpha suppository therapy. Microwave therapy showed a better effect on cervical appearance over laser therapy in the women with grade II and III and also improved cervical appearance over interferon-alpha suppository therapy. There was no difference in grade I women. Microwave therapy showed less adverse bleeding than laser therapy during the treatment. However, the methodological quality of the three RCTs was generally low. No trial compared treatment to no intervention and most trials didn't assess relief of symptoms or quality of life and satisfaction, which are very important to women. AUTHORS' CONCLUSIONS: There are no RCTs comparing microwave therapy with other treatments or no treatment in symptomatic women with cervical ectropion. Although microwave therapy improved the appearance of the cervix over both laser therapy and interferon-alpha suppository therapy it is not clear if there is any other benefit for women.
BACKGROUND: Cervical ectropion is considered as one of the most common types of chronic cervicitis in China. Topical treatments for cervical ectropion including microwave tissue coagulation, are widely used in many hospitals in China. Nowadays, the necessary intervention for inflammatory cervical ectopy is controversial. OBJECTIVES: To compare the efficacy and potential side effects of microwave tissue coagulation with other interventions or no intervention in the treatment of cervical ectropion. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2006, Issue 1), MEDLINE (1966 to 2005), EMBASE (1974 to 2005); The Chinese Biomedical Database (CBM, 1978 to 2005), The Chinese Medical Current Contents (CMCC, 1994 to 2005), CAJ Full-text Database (1994 to 2005) and Chinese Scientific Journals Database (1989 to 2005). We also searched related literature on the Internet with search engines such as Google, searched the reference lists of articles and hand searched relevant Chinese journals. SELECTION CRITERIA: Only authentic randomized controlled trials (RCTs) were included. DATA COLLECTION AND ANALYSIS: Two authors independently interviewed the original authors of claimed RCTs published in China and then assessed the quality of the three included RCTs and extracted data. MAIN RESULTS: No studies were found that met the participant inclusion criteria of the protocol. Although three studies were identified as authentic RCTs from 92 potential RCTs, it was not possible to confirm that the participants were symptomatic prior to treatment. Of these three studies two trials compared microwave therapy with laser and one compared microwave therapy with interferon-alpha suppository therapy. Microwave therapy showed a better effect on cervical appearance over laser therapy in the women with grade II and III and also improved cervical appearance over interferon-alpha suppository therapy. There was no difference in grade I women. Microwave therapy showed less adverse bleeding than laser therapy during the treatment. However, the methodological quality of the three RCTs was generally low. No trial compared treatment to no intervention and most trials didn't assess relief of symptoms or quality of life and satisfaction, which are very important to women. AUTHORS' CONCLUSIONS: There are no RCTs comparing microwave therapy with other treatments or no treatment in symptomatic women with cervical ectropion. Although microwave therapy improved the appearance of the cervix over both laser therapy and interferon-alpha suppository therapy it is not clear if there is any other benefit for women.
Authors: C W Critchlow; P Wölner-Hanssen; D A Eschenbach; N B Kiviat; L A Koutsky; C E Stevens; K K Holmes Journal: Am J Obstet Gynecol Date: 1995-08 Impact factor: 8.661
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