Auditing the Use of Colposcopy Versus General Gynecology Clinics to Investigate Women With Postcoital or Intermenstrual Bleeding

Harry, Vanessa N.; Cruickshank, Margaret; Parkin, David

doi:10.1097/01.lgt.0000245049.67965.39

Cited by 7 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although most women are asymptomatic, the condition can present with irregular discharge and postcoital and intermenstrual bleeding. 6,7 It has been suggested that cervical ectopy may be a potential risk factor for various sexually transmitted diseases, including Chlamydia trachomatis, 8 HIV, 9 and HPV infection. [10][11][12] In a previous work we showed that the detection of HPV DNA was more common in cervical ectopy than in cytology normal controls.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy

Monroy

Aguilar

Lizano

et al. 2010

Journal of Clinical Virology

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy

Monroy

Aguilar

Lizano

et al. 2010

Journal of Clinical Virology

View full text Add to dashboard Cite

“…The clinical relevance of HPV infection in women with cervical ectopy remains unclear as cervical ectopy is not considered a malignant condition. Also, a number of women with cervical ectopy suffer from bothersome symptoms like abundant leucorrhoea, postcoital and intermenstrual bleeding, pelvic pain and recurrent cervicitis, that can impact their quality of life ( Harry et al., 2007 ; Hua et al., 2012 ; Cekmez et al., 2016 ). The presence of chronic symptoms, along with the risk of further infections, warrants treatment of cervical ectopy, mainly cauterization of the area ( Machado et al., 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Altered Vaginal Microbiota Composition Correlates With Human Papillomavirus and Mucosal Immune Responses in Women With Symptomatic Cervical Ectopy

López-Filloy

Cortez

Gheit

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Cervical ectopy is a benign condition of the lower genital tract that is frequently detected in women of reproductive age. Although cervical ectopy is regarded as a physiological condition, some women experience symptoms such as leucorrhoea, persistent bleeding and recurrent vaginal infections that require medical intervention. Cervical ectopy has not been linked to cervical cancer, but it is thought to facilitate the acquisition of sexually transmitted diseases (STDs), like Human Papillomavirus (HPV) infection, as it provides a favorable microenvironment for virus infection and dissemination. We and others have described the presence of oncogenic HPV types in women with symptomatic cervical ectopy. The relevance of this finding and the impact of symptomatic cervical ectopy on the cervicovaginal microenvironment (vaginal microbiota, immune and inflammatory responses) are currently unknown. To shed some light into the interplay between HPV, the vaginal microbiota and mucosal immune and inflammatory responses in the context of this condition, we enrolled 156 women with symptomatic cervical ectopy and determined the presence of HPV using a type-specific multiplex genotyping assay. Overall, HPV was detected in 54.48% women, oncogenic HPV types were found in more than 90% of HPV-positive cases. The most prevalent HPV types were HPV16 (29.4%), HPV31 (21.17%) and HPV18 (15.29%). Next, we evaluated the vaginal microbial composition and diversity by 16S rDNA sequencing, and quantified levels of cytokines and chemokines by flow cytometry using bead-based multiplex assays in a sub-cohort of 63 women. IL-21 and CXCL9 were significantly upregulated in HPV-positive women (p=0.0002 and p=0.013, respectively). Women with symptomatic cervical ectopy and HPV infection had increased diversity (p<0.001), and their vaginal microbiota was enriched in bacterial vaginosis-associated anaerobes (Sneathia, Shuttleworthia, Prevotella, and Atopobium) and depleted in Lactobacillus spp. Furthermore, the vaginal microbiota of women with symptomatic cervical ectopy and HPV infection correlated with vaginal inflammation (IL-1β, rho=0.56, p=0.0004) and increased mucosal homeostatic response (IL-22, rho=0.60, p=0.0001). Taken together, our results suggest that HPV infection and dysbiotic vaginal communities could favor a vaginal microenvironment that might delay the recovery of the cervical epithelium in women with symptomatic cervical ectopy and favor STDs acquisition.

show abstract

“…It has been shown that all symptomatic women under 65 years and with cervical cancer have PCB (Slater, 1995). Chlamydia infection is the most important cause of PCB in women under 35 years, while for those under 35 years is cervix cancer or endometriosis (Harry et al, 2007). Women with suspicious cervix cancer firstly should undergo clinical examination, if there is evident appearance of tumor only Pap smear test is performed.…”

Section: Introductionmentioning

confidence: 99%

Comparison Results of Pap Smear and Colposcopy and Histopathology in Women with Post-Coital Bleeding

Cheraghi¹,

Jolodarian²,

Masoumi³

et al. 2015

Research J. of Obstetrics and Gynecology

View full text Add to dashboard Cite

This study was designed to compare results of Pap-smear and colposcopy and histopathology in women with Post Coital Bleeding (PCB) at any age. A cross-sectional study conducted on 50 women with PCB. Patients were referred to Colposcopy Clinic of Imam Khomeini Hospital (University affiliated), Ahvaz, Iran in 2013. Demographic data, cytological, colposcopic and histopathology results were recorded. Cytological results were classified into normal, inflammatory, high grade squamous, Atypical Glandular Cells (AGC), Low Grade Intraepithelial Lesions (LSIL) and Interepithelial lesions. Colposcopic findings were reported as normal, abnormal, unsatisfactory and invasive carcinoma suspicious. In all cases, Papanicolaou smears and colposcopy were performed by the same skilled gynecologist. We evaluated 50 patients with PCB. The mean age of patients was 33.66±5.54. Of 50, 8(16%) patients were below than 40 years. 23 (46%) of patients did not use any contraceptive. Comparison of the mean score of age between normal and abnormal histopathological results did not show statistically significant difference (33.55±3.38, 33.69±6.04 years, respectively, p value = 0.9). The PCB was never seen in nulliparous, while it had high frequency in multipara 47 (96%) patients. Normal and abnormal histopathological results showed significance difference regarding multipara risk factor (11(22%) and 36(72%), respectively, p value <0.0001). In summary, our findings mostly were consistent with previously published literature in other population groups. Especially, our results regarding invasive cancer in women with PCB alarm us to investigate such cases using colposcopy and histopathology.

show abstract

Auditing the Use of Colposcopy Versus General Gynecology Clinics to Investigate Women With Postcoital or Intermenstrual Bleeding

Abstract: Most patients with PCB and IMB will not have a serious abnormality. Our study proposes that a new PCB/IMB outpatient service can improve the efficiency of treatment of these women by providing appropriate guidelines to standardize their care.

Cited by 7 publications

References 15 publications

Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy

Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy

Altered Vaginal Microbiota Composition Correlates With Human Papillomavirus and Mucosal Immune Responses in Women With Symptomatic Cervical Ectopy

Comparison Results of Pap Smear and Colposcopy and Histopathology in Women with Post-Coital Bleeding

Contact Info

Product

Resources

About