Seema Beniwal1, Binni Makkar2, Swaraj Batra3, Gauri Gandhi4, Deepti Goswami4, Vijay Zutshi5. 1. Consultant, Karan Hospital , Bijnour, Uttarpradesh, India . 2. Clinical Associate, Fortis Hospital , Shalimar Bagh, New Delhi, India . 3. Head of Department, Department of Obstetrics and Gynaecology, Hamdard Institute of Research and Medical Sciences , New Delhi, India . 4. Professor, Department of Obstetrics and Gynaecology, Maulana Azad Medical College , New Delhi, India . 5. Senior Specialist, Department of Obstetrics and Gynaecology, Safdarjung Hospital , New Delhi, India .
Abstract
INTRODUCTION: Colposcopy is an important diagnostic tool in the evaluation of patients with abnormal pap smears. However, in 10-20% transformation zone (TZ)/squamo-columnar junction is not completely visualized and these patients are deemed to have an incomplete colposcopy examination. Such patients usually require conization, a procedure associated with significant morbidity. Various agents like misoprostol, estrogens and laminaria tents have been used in the past to overcome the non-visualization of TZ. AIM: The present study was conducted with the aim to compare the efficacy of vaginal versus oral estradiol administration in overcoming incomplete colposcopy. MATERIALS AND METHODS:Forty patients with non/partially visualized TZ during colposcopy were recruited for the study. These patients were randomly distributed into two groups: In Group I, 25μg estradiol was administered intravaginally daily for seven consecutive days followed by a repeat colposcopy on day 8. In Group II, a seven day course of 25μg oral estradiol was followed by a repeat colposcopy on day 8. The efficacy of the two regimens in improving visualization of the TZ on colposcopy and their adverse effect profile was compared. RESULTS: Vaginal estradiol had an overall efficacy of 70% in improving visualization of the TZ as compared to oral estradiol which was effective in 50% of patients (p-value-0.19). Major adverse effects in both the group of patients were nausea and vaginal discharge with no significant differences among the two groups. CONCLUSION: Both vaginal and oral estrogens had comparable efficacy and similar adverse effect profile in improving visualization of the TZ.
RCT Entities:
INTRODUCTION: Colposcopy is an important diagnostic tool in the evaluation of patients with abnormal pap smears. However, in 10-20% transformation zone (TZ)/squamo-columnar junction is not completely visualized and these patients are deemed to have an incomplete colposcopy examination. Such patients usually require conization, a procedure associated with significant morbidity. Various agents like misoprostol, estrogens and laminaria tents have been used in the past to overcome the non-visualization of TZ. AIM: The present study was conducted with the aim to compare the efficacy of vaginal versus oral estradiol administration in overcoming incomplete colposcopy. MATERIALS AND METHODS: Forty patients with non/partially visualized TZ during colposcopy were recruited for the study. These patients were randomly distributed into two groups: In Group I, 25μg estradiol was administered intravaginally daily for seven consecutive days followed by a repeat colposcopy on day 8. In Group II, a seven day course of 25μg oral estradiol was followed by a repeat colposcopy on day 8. The efficacy of the two regimens in improving visualization of the TZ on colposcopy and their adverse effect profile was compared. RESULTS: Vaginal estradiol had an overall efficacy of 70% in improving visualization of the TZ as compared to oral estradiol which was effective in 50% of patients (p-value-0.19). Major adverse effects in both the group of patients were nausea and vaginal discharge with no significant differences among the two groups. CONCLUSION: Both vaginal and oral estrogens had comparable efficacy and similar adverse effect profile in improving visualization of the TZ.
Authors: Jacob Bornstein; James Bentley; Peter Bösze; Frank Girardi; Hope Haefner; Michael Menton; Myriam Perrotta; Walter Prendiville; Peter Russell; Mario Sideri; Björn Strander; Silvio Tatti; Aureli Torne; Patrick Walker Journal: Obstet Gynecol Date: 2012-07 Impact factor: 7.661
Authors: Simon M Manga; Margaret I Liang; Yuanfan Ye; Jeff M Szychowski; Kathleen L Nulah; Alan T Tita; Isabel Scarinci; Warner K Huh Journal: Gynecol Oncol Rep Date: 2022-03-01