Evaluation of women presenting with postcoital bleeding by cytology and colposcopy.
OBJECTIVE
To evaluate women with postcoital bleeding (PCB) by clinical examination, cytology, colposcopy, and histopathology.


METHODS
A cross-sectional study of 123 women with PCB, who were referred to the Colposcopy Clinic of Arash Hospital, Tehran, over a 2-year period.


RESULTS
Clinical examinations revealed cervical polyps in 18 women and ectropion in 14. Cervical cytology identified 13 patients with atypical squamous cells of undetermined significance, 2 with atypical glandular cells, 4 with low-grade squamous intraepithelial lesions, and 3 with high-grade squamous intraepithelial lesions. Colposcopy indicated invasive cancer in 1 patient. Transitional zones appeared normal in 39.8% of the cohort, were atypical grade 1 in 33.3%, and atypical grade 2 in 4.9%. Fourteen abnormalities were detected at histology, including 1 squamous cell carcinoma, 1 low-grade glandular neoplasm, 9 cervical intraepithelial neoplasia (CIN) grade 1, 2 CIN grade 2, and 1 CIN grade 3. The sensitivity and specificity of cytology were 50% and 86.5%, respectively. A total of 21.4% of abnormal pathologies were missed using colposcopy, which had a sensitivity of 79%.


CONCLUSIONS
Because of its higher sensitivity, colposcopy can be recommended for the investigation of persistent PCB, even in the presence of normal cytology.
Tehranian
Afsaneh
A
Department of Gynecology and Obstetrics, Roointan-Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. afsanehtehranian@yahoo.com
Rezaii
Negar
N
Mohit
Mitra
M
Eslami
Bita
B
Arab
Malihe
M
Asgari
Zahra
Z
D000328:Adult; D003075:Coitus; D003127:Colposcopy / Q000379:methods*; D003430:Cross-Sectional Studies; D003584:Cytological Techniques; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis; D012680:Sensitivity and Specificity; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology; D014592:Uterine Hemorrhage / Q000209:etiology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology