Can vaginal misoprostol effectively increase rate of a satisfactory colposcopy? A randomized double-blind placebo-controlled trial.
OBJECTIVE
To evaluate the effectiveness of vaginal misoprostol in overcoming an unsatisfactory colposcopy in the patients who had abnormal cervical cytology and to evaluate side effects of vaginal misoprostol.


METHODS
Sixty patients with an unsatisfactory colposcopy during the period of September 2007-November 2008 were recruited and randomly allocated to receive either two tablets of 200 microg misoprostol (400 microg) or two tablets of similar-looking placebo vaginally. Colposcopic re-examination was performed approximately 6 h later. The results and side effects before and 2 weeks after the colposcopic re-examination were recorded.


RESULTS
Six out of 30 patients in the misoprostol group (20.0%) had a satisfactory colposcopic re-examination compared with 2 out of 27 patients (7.4%) in the placebo group without statistically significant difference (P = 0.172). Three patients in the placebo group dropped out due to not present at the appointment time. Six out of 30 patients (20.0%) and 1 out of 30 patients (3.3%) in the misoprostol group had side effects before and 2 weeks after the colposcopic re-examination orderly. Twenty-seven patients in the placebo group did not have any side effects before and 2 weeks after the colposcopic re-examination. All side effects occurred were minimal and well tolerated.


CONCLUSIONS
Four hundred micrograms of vaginal misoprostol were not proved to be effective in converting an unsatisfactory to a satisfactory colposcopy.
Thanapprapasr
Duangmani
D
Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. radtn@mahidol.ac.th
Wilailak
Sarikapan
S
Ayudhya
Nathpong Israngura Na
NI
Lertkhachonsuk
Arb-Aroon
AA
Likittanasombut
Puchong
P
Chittithaworn
Suwicha
S
Charakorn
Chuenkamon
C
Weerakiet
Sawaek
S
D003127:Colposcopy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D010919:Placebos; D011300:Preoperative Care; D011379:Prognosis; D013488:Suppositories; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014621:Vagina / Q000187:drug effects*
D010120:Oxytocics; D010919:Placebos; D013488:Suppositories; D016595:Misoprostol