Baseline colposcopic findings in women entering studies on female vaginal products

OʼNeill, Erica; Reeves, Matthew F.; Creinin, Mitchell D.

doi:10.1016/j.contraception.2008.04.002

Cited by 14 publications

(12 citation statements)

References 15 publications

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“…In the current study, erythema was the only colposcopic finding that was increased in the nonoxynol-9 group; however, erythema has not generally been considered to be a biomarker for increased susceptibility to HIV or other STDs (31). …”

Section: Discussionmentioning

confidence: 51%

Optical Coherence Tomography Compared With Colposcopy for Assessment of Vaginal Epithelial Damage

Vincent

Stanberry

Moench

et al. 2011

Obstetrics &Amp; Gynecology

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Objective Colposcopy has been used to detect epithelial damage with vaginal microbicides. In animal models, optical coherence tomography (OCT) provided increased sensitivity over colposcopy in detecting epithelial injury. This randomized double-blinded clinical study compared OCT to colposcopy for the evaluation of epithelial injury in women using placebo or nonoxynol-9. Methods Thirty women aged 18–45 were randomized to use hydroxyethyl cellulose placebo or nonoxynol-9 vaginal gel twice daily for 5.5 days. Imaging with colposcopy and OCT was performed prior to product use, after the last dose, and 1 week later. Colposcopy was graded using standard criteria. OCT images were scored for epithelial integrity based on a published scoring system and measured for epithelial thickness. Results Colposcopy findings and OCT scores and epithelial thicknesses were similar between treatment groups at baseline. After treatment, there were significant differences between the nonoxynol-9 (1.37) and control group (1.15) OCT scores (p<0.001, indicating epithelial injury, and there was epithelial thinning in the nonoxynol-9 group (237μm) compared to the control group (292μm) (p=0.008). There were no significant posttreatment colposcopic differences in epithelial disruption between treatment groups, with only increased erythema noted after nonoxynol-9 use (p=0.02). Conclusion OCT detected epithelial disruption and thinning not identified by colposcopy. Vaginal epithelial thickness, a measure previously available only through biopsy, decreased after nonoxynol-9 use, a finding that may contribute to increased susceptibility to HIV after frequent use. OCT shows promise for the noninvasive clinical assessment of vaginal epithelial damage. Clinical Trial Registration UMIN Clinical Trials Registry, www.umin.ac.jp/ctr/index.htm, R000006186.

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Section: Discussionmentioning

confidence: 51%

Optical Coherence Tomography Compared With Colposcopy for Assessment of Vaginal Epithelial Damage

Vincent

Stanberry

Moench

et al. 2011

Obstetrics &Amp; Gynecology

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“…The endometrial biopsies were normal in all cases, thereby reaffirming the endometrial safety of this type of contraceptive method [76]. In short, there is a substantial body of evidence that rules out the possibility that the hormonal derivatives released by the ring or the presence of the device (a potentially irritating stimulus) induce additional lesions in the vagina [73][74][75][76]. Table 3 summarises the profile of the other adverse reactions described for the vaginal ring, comparing them in almost all cases with oral administration [46,47,49,50].…”

Section: Safety Of the Vaginal Ringmentioning

confidence: 71%

“…However, these effects seemed to be related more with the specific physical and morphological characteristics of the ring in question than with the hormones that it released, given that in another trial with a different model (IVR-2) lesions were avoided by reducing the size of the ring [73]. Furthermore, it has recently been suggested that most colposcopic lesions of the lower genital tract represent mere physiological variations of normality and are quite frequent among young women [74].…”

Section: Safety Of the Vaginal Ringmentioning

confidence: 95%

Is the Vagina an Adequate Route for the Administration of Hormonal Contraceptives?

Lete

Dueñas²,

Esplugues³

et al. 2010

CDM

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The vaginal route of drug administration provides women with a valid alternative to more conventional methods of contraception. Drugs absorbed in the upper part of the vagina can bypass the liver and, if metabolized, are subject to a reduced hepatic first-pass effect. Current vaginally-administered contraceptive formulations deliver similar doses of gestagens to those provided by oral methods but release lower amounts of oestrogens. This results in a systemic exposure to gestagens similar to that achieved via other routes, thereby maintaining contraceptive efficacy while limiting systemic, but not uterine, exposure to oestrogen. In this way, the probability of systemic oestrogen-related adverse effects are theoretically reduced without compromising cycle control. In addition, the fact that the effects of a contraceptive ring last a complete cycle makes it more user-friendly than other methods and results in better patient compliance. The present review will explain in detail the specificities of this route of delivery of hormonal contraception and will compare it to more classic forms of contraception received via the oral (pill), intramuscular (injected), transdermic (patch) and subcutaneous (implants) routes of administration.

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“…Colposcopy is a well-established procedure for examining the uterine cervix under magnification (6)(7)(8). When lesions are treated with 3-5% acetic acid, colposcopy can detect and recognize cervical intraepithelial neoplasia (CIN) (6).…”

Section: Introductionmentioning

confidence: 99%

Application of deep learning to the classification of uterine cervical squamous epithelial lesion from colposcopy images combined with HPV types

et al. 2019

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The aim of the present study was to explore the feasibility of using deep learning, such as artificial intelligence (AI), to classify cervical squamous epithelial lesions (SILs) from colposcopy images combined with human papilloma virus (HPV) types. Among 330 patients who underwent colposcopy and biopsy performed by gynecological oncologists, a total of 253 patients with confirmed HPV typing tests were enrolled in the present study. Of these patients, 210 were diagnosed with high-grade SIL (HSIL) and 43 were diagnosed with low-grade SIL (LSIL). An original AI classifier with a convolutional neural network catenating with an HPV tensor was developed and trained. The accuracy of the AI classifier and gynecological oncologists was 0.941 and 0.843, respectively. The AI classifier performed better compared with the oncologists, although not significantly. The sensitivity, specificity, positive predictive value, negative predictive value, Youden's J index and the area under the receiver-operating characteristic curve ± standard error for AI colposcopy combined with HPV types and pathological results were 0.956 (43/45), 0.833 (5/6), 0.977 (43/44), 0.714 (5/7), 0.789 and 0.963±0.026, respectively. Although further study is required, the clinical use of AI for the classification of HSIL/LSIL by both colposcopy and HPV type may be feasible.

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Baseline colposcopic findings in women entering studies on female vaginal products

Cited by 14 publications

References 15 publications

Optical Coherence Tomography Compared With Colposcopy for Assessment of Vaginal Epithelial Damage

Optical Coherence Tomography Compared With Colposcopy for Assessment of Vaginal Epithelial Damage

Is the Vagina an Adequate Route for the Administration of Hormonal Contraceptives?

Application of deep learning to the classification of uterine cervical squamous epithelial lesion from colposcopy images combined with HPV types

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