ABSTRACT
A 40-year-old woman (nulligravida) presented with abnormal cervical cytology. At colposcopy a double external uterine os was discovered with a levonorgestrel intra uterine contraceptive device placed in the opening on the left side. Ultrasound revealed an uterus bicornis bicollis. Despite frequent examinations, the abnormality had not been discovered earlier. Therefore, contraception and cervical cytology sampling had most likely been inadequate.
Subject(s)
Cervix Uteri/abnormalities , Cervix Uteri/cytology , Intrauterine Devices, Medicated , Adult , Cervix Uteri/drug effects , Colposcopy , Diagnosis, Differential , Female , Humans , Intrauterine Devices, Medicated/adverse effects , Vaginal SmearsABSTRACT
Early treatment of cervical intraepithelial neoplasia (CIN) significantly reduces the risk of invasive cancerous progression. Residual and recurrent high-grade CIN should be detected and retreated in an early phase. Therefore, a postsurgery cytologic follow-up protocol was introduced at 3, 6, 9, and 12 months and yearly thereafter for 5 years. The aim of this study is to evaluate the long-term experience in treating high-grade CIN using large-loop excision of the transformation zone (LLETZ). Additionally, the long-term follow-up in this study gains the opportunity to document the pattern of disease recurrence beyond 5 years. The average follow-up of the 1696 women included in this study was 6.5 years. Overall, 8.5% of the patients who underwent LLETZ showed a high-grade repetitive CIN and three patients had invasive carcinoma. Eighty percent of those lesions were probably residual, whereas 20% of all high-grade repetitive lesions appeared more than 2 years after initial surgery and were considered recurrent lesions. Half of the recurrent lesions occurred more than 5 years after LLETZ.
