Electrofulguration for low-grade squamous intraepithelial lesions of the cervix (CIN 1).
OBJECTIVE
To evaluate the therapeutic efficacy and adverse events of electrofulguration for the treatment of cervical intraepithelial lesion grade 1 (CIN 1).


METHODS
Women aged 19 years and older received electrofulguration for histologically proven exocervical CIN 1. They were followed up at 3, 6, and 12 months with cytologic analysis, colposcopy, and, when indicated, histologic examination. Therapeutic success was defined as absence of disease at 12 months after therapy. Adverse effects were recorded during and after the procedure.


RESULTS
Of 78 women treated, 32 (41.0%) were lost to follow-up and 6 patients (7.7%) were retreated. Using intent-to-treat definition including patients lost to follow-up, 40 of 78 (52.6%) were free of disease at the 1-year follow-up visit. Excluding patients lost to follow-up, cure rates were 87% (40/46) and 100% (40/40) after single and repeat treatment, respectively. Adverse effects included mild to moderate discomfort (78%), intermittent spotting (70%), and pelvic pain (44%). The procedure lasted 2 minutes in 83% of cases and was easy to perform.


CONCLUSIONS
Electrofulguration under local anesthesia is an attractive ablative treatment method for exocervical CIN 1 and compares favorably with cryocoagulation as per review of the literature.
Roy
Marie-Christine
MC
Department of Obstetrics & Gynecology, Centre Hospitalier Université Laval, Quebec, Canada.
Mayrand
Marie-Hélène
MH
Franco
Eduardo
E
Arseneau
Jocelyne
J
Ferenczy
Alex
A