Regeneration of uterine cervix at 6 months after large loop excision of the transformation zone for cervical intraepithelial neoplasia.
OBJECTIVE
To sonographically investigate cervical regeneration 6 months after large loop excision of the transformation zone (LLETZ) conisation for cervical intraepithelial neoplasia (CIN) pathology.


METHODS
Prospective observational study.


METHODS
University Hospital setting.


METHODS
Women having LLETZ conisation for intraepithelial lesions in response to abnormal Papanicolaou smears or colposcopic findings.


METHODS
Cervical dimensions were estimated before conisation and at 6 months with three-dimensional sonography and use of vocal™ software. Cone depth was measured using a ruler before fixation, and cone volume was measured using a volumetric tube and the fluid displacement technique. Cervical regeneration was sonographically estimated.


METHODS
Correlation of cervical volume regeneration with percentage of initial cervical volume excised and remaining cervical tissue immediately after conisation.


RESULTS
A cohort of 112 women were initially recruited over a 2-year period and 73 women presented for ultrasound follow up at 6 months. Multivariate linear regression analysis showed that for women matched for age and initial cervical volume, if cervical volume excised was increased by 1% then regeneration of tissue deficit at the cervical crater was reduced by 1.37%. There also seemed to be a cutoff point suggesting that when >14% of initial cervical volume was excised, the tissue deficit at the cervical crater at 6 months was restored by <75% and there was >25% of remaining tissue deficit.


CONCLUSIONS
Cervical regeneration at 6 months after excision is dependent on the percentage of initial cervical volume excised and on the remaining cervical tissue immediately after conisation. The greater the cone and the less cervical tissue remaining, the less the degree of cervical regeneration achieved.
First Department of Obstetrics and Gynaecology, Alexandra Hospital, University of Athens, Athens, Greece. dipapoutsis@yahoo.com
D
D
Papoutsis
A
A
Rodolakis
S
S
Mesogitis
M
M
Sotiropoulou
A
A
Antsaklis
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000473:pathology / Q000502:physiology* / Q000601:surgery; D019092:Conization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D011446:Prospective Studies; D012038:Regeneration; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*