CERVICAL CYTOLOGIC AND COLPOSCOPIC CHANGES IN CASES USING IUDs FOR A LONG TIME

Year 2017, Volume: 2 Issue: 1, 1 - 9, 03.06.2017

Yılda Arzu Aba , Bulat Aytek Şık Mehtap Şentürk Sekan Kumbasar Elif Sümer Özlem Dülger

https://doi.org/10.23884/ijhsrp.2017.2.1.01

Abstract

The present study aims to examine cervical cytologic
and colposcopic changes in patients using IUDs for a long time. Our study is a
cross-sectional study that enrolled 188 cases. 62 monogamous patients without a
history of sexually transmitted infection, and using an IUD for 5 years or more
were included in the study group (Group 1). 126 patients without a previous
anamnesis of IUD use and patients in whom IUDs were not detected during the
examination were enrolled in the control group (Group 2). All patients
underwent a colposcopic examination and a smear was obtained. Patients with a
history of HPV were excluded from the study. Smear test results and findings of
colposcopic examination of the study and control groups were compared. Gravida,
Parity, Number of Births, age at first coitus were determined through the
patients’ histories. The mean age of the patients in Group 1 was 38.67, age at
first coitus was 19.49, and the mean age in Group 2 was 39.11 and age at first
coitus was 18.95 years. There was a significant difference detected in the
comparison of Gravida (p=0.03), while parity and NSD parameters were not found
significantly different (p=0.15, p=0.14). Rates of mild ectopy in Group 1 and
Group 2 were 25.8% and 19.18%, moderate ectopy were 25.8%, 28.6%, severe ectopy
were 11.3% and 23.8%, respectively. Polyp detection rate was found 16.7% in
Group 1, while it was 40.9% in Group 2. On the other hand, leukoplakia
detection rate was 8.3% in Group 1, while it was found 18.2% in Group 2. no
statistically significant difference was detected between the two groups. F.
Mosaic rate in patients using IUDs was found significantly lower (χ²= 3.74 p= 0.05). As a
result of our study, no significant difference could be shown in NTZ, ATZ,
Asetowhite, C.Mosaic, F.Punction, C.Punction, Atypical Vascularization, and
Schiller rates.

Keywords

Cervical smear, Colposcopy, Inflammatory changes

References

• [1]Sivin I, Schmidt F. Effectiveness of IUDs: A review. Contraception, (36)1987, pp:55.
• [2]Çiçek M, Akyürek C, Çelik Ç, Haberal A. Kadın Hastalıkları ve Doğum Bilgisi, Birinci Baskı, Ankara, Güneş Kitabevi. 2004: 566
• [3]Atasü T &Sahmay S. Jinekoloji. ÜniversalDilHizmetleriveYayıncılık, İstanbul,2000, pp:689
• [4]Farley TMM, RosenborgMj, Rowe PJ, et al. Intrauterine devices and pelvic inflammatory disease: an international perspective. Lancet,(330)1991, pp:785.
• [4] Di Saia, Creasman WJ.Clinical Gynecologic Oncology, 8th Edition, St. Lois Missouri CW Mosby2012, pp: 353.
• [5] Richart RM. A Modified terminology for cervical intraepithelial neoplasia ,Obstet andGynecol.75(1):1990, pp:131-133.
• [6] Spitzer M & Burton AK, Human papilloma Virus related diseases in the female patient, Urologic clinics of North America, 19(1): 1992,pp:131-133.
• [7] Hall JE ,Walton L. Displasia of cervix ,Am J Obstet and Gynecol.100(5):1968, pp:662-71.
• [8] Kolstad P.Carcinoma of the cervix.Stage 0: Diagnosis and treatment,Am J ObstetGynecol.198615;96(8):1098–1111.
• [9] Stafl A. &Wattingly RF. Colposcopic diagnosis of cervical neoplasia ,Obstet and Gynecol,41(2):1973, pp:168-176.
• [10] Kwikkel NJ, Benzemer PP, Helmerhorst TJ, Quaak MJ, Stolk JG:Predictive value of a positive endocervicalcurretage in diagnosis and treatment of CIN.GynecolOncol.24(2)1986, pp:162-70.
• [11] Spirtos NM, Schlaerth JB, Dablaing G, Morrow CP. A critical evaluation of the endocervicalcurretage.Obstet Gynecol. 1987 Nov;70(5):729-33.
• [12] Wright C. Contemporary Colposcopy, Obstetrics and Gynecology Clinics of NorthAmerica,20(1)1993, pp:83-110.
• [13] Frisch LE.İnflamatoryatypia and the false-negative smear in cervical intraepitelialneoplasia. ActaCytol, 96(2)1987,pp:873-7.
• [14] Güner, H. JinekolojikOnkoloji,Rota Tıp Yayıncılık, Third Edition, 2010, pp:46.
• [15] LuthraUsha K., Prabhakar AK., Bhatnagar P. & Aggarwal SS. Role of copper containing intrauterine devices in cervical carcinogenesis- 48 months experience.ActaCytology, (66)1980,pp:246.
• [16] Fiore N. Epidemiological data, cytology and colposcopy in UID ( intrauterine device), E-P (estro- progestogens) and diaphram users. Study of cytological changes of endometrium UID related. Clin EXP ObstetGynecol (13)1986, pp:34-42.
• [17] Howard O.Zuher N, Beach C, Hatcher RA., Tyler CW. Contraceptive choice and prevalence of cervical dysplasia and carcinoma in situ. ACOG, 124(6):1976, pp: 573–57.
• [18] Risse EK, Beerthuizen RJ, Vooijs GP.Cytologic and histologic findings in women using an IUD.Obstet Gynecol. 58(5):1981, pp:569-73.
• [19] Fahmy K, Ismail H, Sammour M, el-Tawil A, Ibrahim M.Cervical pathology with intrauterine contraceptive devices- a cyto-colpo-pathological study. Contraception. 41(3)1990, pp:317-22.
• [20] Hsu Ct, Hsu ML, Hsieh TM, Lin CT, Wang TT, Lin YN. Uterine malignancy developing after long term use of IUCD additional report. Asia J ObstetGynaecol(15)1989, pp : 237-243.
• [21] Pike MC. Reducing Cancer risk in women through lifestyle mediated changes in hormone levels. Cancer Detect Prev(14)1990, pp:595-607.
• [22] Lassise DL, Savitz DA, Hamman RF, Barón AE, Brinton LA, Levines RS.Invasive cervical cancer and intrauterine device use.Int J Epidemiol. 20(4):1991, pp:865-70.
• [23] Engineer A. D, Misra J S, Tandon P. Comparative cervical cytology in women using different types of copper IUDs.Indian J Med Res,74:1981, pp:23-30.