The removal of a cervical polyp is routinely accompanied by a fractionated dilatation and curettage (D&C) in various institutions. In order to assess the necessity of performing a D&C on all the patients admitted with the diagnosis of a cervical polyp, we reviewed the charts of 362 patients admitted for a cervical polypectomy and D&C during a 5-year period. The procedure was performed on a day clinic basis under general anesthesia. No serious complications were noted. In 218 women (60%) the discovery of the cervical polyp was incidental and in this group no malignant change was found in the polyp or in the endometrium. Six cases of atypical hyperplasia and 2 cases of adenocarcinoma of the endometrium were found in the symptomatic group of patients (40%). Removal of the polyp as an outpatient procedure is recommended of the asymptomatic patient. Hospitalization and removal of the polyp under general anesthesia, accompanied by D&C should be reserved for the symptomatic patients only, or even then, replaced by ambulatory polypectomy and endometrial sampling.
BackgroundThe multinational CHOICE (Contraceptive Health Research Of Informed Choice Experience) study evaluated the effects of structured counseling on women’s contraceptive decisions, their reasons for making those decisions, and their perceptions of combined hormonal contraceptive (CHC) methods in eleven countries. The aim of this paper to present data from the 1,802 women participating in Israel’s CHOICE program.MethodsWomen (aged 17–40 years) who consulted their health care providers about contraception and who would consider a CHC method qualified to participate. After indicating their intended CHC method, the women received counseling about the daily pill, weekly patch, and monthly vaginal ring. After counseling, the women completed a questionnaire about their contraceptive decisions.ResultsBefore counseling, 67%, 6%, and 5% of women (mean age 27 years) intended to use the pill, patch, or ring, respectively. Counseling significantly influenced the women’s CHC choice, with 56%, 12%, and 23% of women selecting the pill, patch, or ring (P<0.0001 for all contraceptive methods versus before counseling). Logistic regression analysis suggested that age significantly increased the probability of switching from the pill to the ring.ConclusionAlthough the pill was the most popular choice overall, counseling appeared to influence Israeli women’s contraceptive decisions, with significantly more women selecting the patch. More than four times as many women selected the ring after counseling than before counseling.
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