RESUMEN
Objetivo: Evaluar la endocervicoscopia como técnica diagnóstica y terapéutica de las lesiones endocervicales más frecuentes. Métodos: Estudio prospectivo y descriptivo que incluyó 46 pacientes referidas para histeroscopia, entre agosto 2015 - enero 2016. Se plantea a las pacientes evaluación de cuello uterino para despistaje de infección por virus de papiloma humano. Se realiza colposcopia, citología, vaginohisteroscopia, instilación de 1,5 ml de ácido acético al 5 % en canal endocervical y reevaluación histeroscópica. Se recolectaron los hallazgos colposcópicos, endocervicoscópicos, citológicos y de anatomía patológica. Resultados: Hubo 31 pacientes (67,39 %) sin atipias colposcópicas y 15 (32,60 %) con atipias. En canal endocervical, 34 (73,91 %) sin atipias y 12 (26,08 %) con atipias (acetoblancas y papilomatosis). Otros hallazgos endocervicales: pólipos 12 (26,08 %), estenosis 7 (15,21 %), sinequias 7 (15,21 %). Resultados citológicos: 22 (47,82 %) resultados normales, 9 (19,56 %) lesiones de bajo grado, o atipias de significado incierto. Se tomaron 15 biopsias de exocérvix con asa, 13 (86,66 %) positivas para virus de papiloma humano y 12 biopsias de endocérvix con pinza de biopsia histeroscópica, de las cuales 11 (91,66 %) resultaron positivas para virus de papiloma humano. Conclusiones: Se encontró una incidencia de 26,08 % de lesiones atípicas endocervicales por virus de papiloma humano diagnosticadas por colposcopia y endocervicoscopia, siendo esta una técnica segura y de fácil ejecución en consultorio, que permite realizar evaluación precisa de las lesiones de la mucosa endocervical, permitiendo la toma de biopsia bajo visión directa, complementando de forma magistral a la colposcopia.
Objective: To evaluate endocervicoscopy as a diagnostic and therapeutic technique for the most frequent endocervical lesions. Methods: A prospective and descriptive study involving 46 patients referred for hysteroscopy between August 2015 and January 2016. Patients were assessed for cervical screening for screening for human papillomavirus infection. Colposcopy, cytology, vaginohysteroscopy, instillation of 1.5 ml of 5% acetic acid in the endocervical canal and hysteroscopic reevaluation were performed. The colposcopy, endocervicoscopic, cytological and pathological findings were collected. Results: There were 31 patients (67.39%) without colposcopic atypia and 15 (32.60%) with atypia. In the endocervical canal, 34 (73.91%) had no atypia and 12 (26.08%) had atypia (acetowhite and papillomatosis). Other endocervical findings: polyps 12 (26.08%), stenosis 7 (15.21%), synechia 7 (15.21%). Cytological results: 22 (47.82%) normal findings, 9 (19.56%) low grade lesions, or atypia of uncertain significance. Fifteen biopsies of exocervix with loop, 13 (86.66%) positive for human papillomavirus and 12 biopsies of endocervix with hysteroscopic biopsy had been taken, of which 11 (91.66%) were positive for human papillomavirus. Conclusions: An incidence of 26.08% of atypical endocervical lesions for human papillomavirus was found, which were diagnosed by colposcopy and endocervicoscopy, which is a safe and easy-to-perform technique in the office, which allows an accurate evaluation of the lesions of the endocervical mucosa, allowing the biopsy to be taken under direct vision, complementing in a masterful way the colposcopy.