Prevention of post-cone biopsy cervical stenosis using a temporary cervical stent.
Stenosis of the residual cervix is not an infrequent complication of cone biopsy which may result in subfertility, problems with adequate follow-up and dysmenorrhoea. In an attempt to minimize this complication a temporary indwelling cervical support stent has been developed. This is sutured into the exposed cone bed immediately after cutting the cone specimen and removed 2 weeks later. A pilot study using this device in 33 cold knife conizations has been performed. There were no primary or secondary haemorrhages and no post-conization pelvic infections. At follow-up, 6 months after cone biopsy two patients (6%) had clinical cervical stenosis, and one patient (3%) complained of dysmenorrhoea (although the cervix was not stenosed). The cervical transformation zone was fully visible in 21/33 patients (64%) (95% CI 48 to 80) and follow-up smears contained endocervical cells in 20/33 patients (61%) (95% CI 44 to 78). These results compare very favourably with historical controls from the same unit and suggest that cone biopsy support stents should now be assessed in a prospective randomized trial.
Luesley
D M
DM
University of Birmingham Department of Obstetrics and Gynaecology, Dudley Road Hospital.
Redman
C W
CW
Buxton
E J
EJ
Lawton
F G
FG
Williams
D R
DR
D000328:Adult; D001706:Biopsy / Q000009:adverse effects*; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011897:Random Allocation; D015607:Stents; D002577:Uterine Cervical Diseases / Q000473:pathology / Q000517:prevention & control*