Ridge sign is a highly specific marker for CIN 2 or 3 and associated with HPV 16 and young age.

Inner border is a rare colposcopic phenomenon but highly specific for CIN 2 or 3 in young women.

Hysteroscopic sterilization is a minimally invasive, nonincisional method of permanent sterilization that is a valid alternative to laparoscopic sterilization, the conventional method of female sterilization. Under hysteroscopic guidance, an expanding microinsert is introduced into the proximal portion of each fallopian tube; local fibrosis and, ultimately, complete tubal occlusion occurs within 3 months. This retrospective study examined trends in sterilization in women at an outpatient surgery center and university teaching hospitals following the introduction of Essure hysteroscopic sterilization in 2002. A chart review was conducted on women undergoing interval sterilization procedures and postpartum sterilization procedures between 2002 and 2007. Interventions evaluated included minilaparotomy tubal ligation, laparoscopic sterilization, Essure hysteroscopic sterilization, and postpartum tubal ligation performed after vaginal delivery or at the time of cesarean section.Of the 5509 permanent sterilization procedures examined, 2484 were interval sterilization procedures and 3025 were postpartum tubal ligations. For all interval sterilizations performed during the 6-year-study period, a shift toward Essure hysteroscopic sterilizations from 0.0% to 51.3% corresponded significantly with a decrease in laparoscopic sterilizations from 97.9% to 48.5% (P Ͻ 0.001). During the study period, the number of postpartum tubal ligations performed after vaginal delivery decreased significantly from 7.9% to 3.3% of all vaginal deliveries (P Ͻ 0.001), whereas the number of tubal ligations performed at the time of cesarean section did not change significantly (P ϭ 0.51).These findings suggest the high likelihood that Essure hysteroscopic sterilization will replace the laparoscopic approach as the method of choice for permanent sterilization. ABSTRACTIt is becoming increasingly common to enable a woman to see her ambulatory hysteroscopy procedure on a monitor. However, there is only limited evidence on the potential impact of seeing or not seeing the procedure on patient mood, perception of pain, and patient-physician interaction. This randomized controlled trial compared the effects of seeing or not seeing the screen during an outpatient hysteroscopy procedure on patient's experience. At two outpatient clinics, 157 women scheduled for a hysteroscopy procedure were randomized either to see the screen (n ϭ 81) or not to see the screen (n ϭ 76). Before and after the procedure, the patients completed questionnaires to evaluate various parameters of their experience (mood, pain perception, illness cognitions, and communication with the health professional). After 232Obstetrical and Gynecological Survey Office Gynecology 233ABSTRACT Some investigators have reported that presence of the inner border may be a colposcopic sign for the presence of high-grade cervical neoplasia. The inner border can be defined as a sharp acetowhite demarcation or transformation zone within a less opaque acetowhite area. The association of the colposcopic si...

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