Correlation of colposcopy using Reid colposcopic index with histopathology- a prospective study.

OBJECTIVE: To estimate the diagnostic efficacy of colposcopy & determine the strength of correlation between colposcopic impression using the Reid Colposcopic Index (RCI) and histopathology. MATERIAL AND METHODS: This was a prospective cross sectional study carried out in the colposcopy clinic at KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belgaum from January 2008 to June 2009. A total of 268 women who fulfilled the selection criteria were included in the study. All women underwent colposcopy and a diagnosis was made based on RCI. Colposcopy directed biopsy was obtained from the abnormal areas. In cases where colposcopy did not reveal any lesion, a four quadrant biopsy from the squamocolumnar junction was taken, which served as a gold standard. RESULTS: Three women who had an unsatisfactory colposcopy & eleven women with the diagnosis of cervical cancer were excluded from the analysis. The sensitivity, specificity, positive predictive value & negative predictive value of colposcopy with CIN 1 as a disease threshold was 88.5%, 86.2%, 77% & 93.5% respectively. With CIN 2 as a disease threshold the sensitivity, specificity, positive predictive value & negative predictive value of colposcopy were 85.2%, 99.6%, 95.8% & 98.3% respectively. The degree of correlation between colposcopic impression using RCI & histopathology was high (k=0.73). CONCLUSION: Colposcopy is an indispensable tool in the diagnosis of precancerous lesions & the good correlation between colposcopic impression using RCI & histopathology makes it a reproducible technique which is easy to implement in colposcopy clinics.

Testicular biopsies--histomorphologic patterns in male infertility.

The objective of the present study is to observe the spectrum of histopathological changes in the testicular biopsies of infertile men and to assess if a bilateral biopsy is required to reveal the pathology of infertility in every case or a unilateral biopsy would suffice. Thirty testicular biopsies (21 bilateral and 9 unilateral) were studied from 30 infertile men. The patterns of testicular damage seen in the present study were maturation arrest followed by hypospermatogenesis, Sertoli-cell only syndrome, tubular hyalinisation and one case was associated with normal histology. Comparing the histopathological findings in bilateral biopsies, it was seen that a unilateral biopsy would suffice to reveal the pathology in most instances and a bilateral biopsy is needed only when there is appreciable difference in the size of the testes.