title: Microcolpohysteroscopy: myth or reality?
abstract: OBJECTIVE
  Our aim was to compare the diagnostic accuracy of microcolpohysteroscopy (MCH) and colposcopy-directed biopsies in the detection of precancer and cancer of the uterine cervix.
  
  
  METHODS
  Between January and December 1994, a total of 174 patients underwent colposcopic and MCH examinations. Direct biopsies were obtained under colposcopic and MCH guidance. Diagnostic accuracies of the two methods were compared using the chisquare test and the kappa coefficient.
  
  
  RESULTS
  Colposcopy showed an overall diagnostic accuracy of 39.7% (69 of 174) with a sensitivity of 50.5%, specificity of 23.2%, positive predictive value of 50%, and negative predictive value of 23.5%. The percentage of agreement between MCH diagnosis and histological findings was 92.4% for cervical intraepithelial neoplasia lesions, 92.5% for human papillomavirus, and 100% for invasive cancer. Of the total 174 cases, colposcopy examination was considered satisfactory in 134 (77%) and unsatisfactory in 40 (23%). In the 40 cases when the limits of the squamocolumnar epithelium could not be seen at colposcopy, satisfactory MCH examinations were obtained in cervical lesions measuring no more than 10 mm in endocervical depth (29 cases), and unsatisfactory MCH examinations were obtained in cervical lesions measuring at least 10 mm of endocervical depth (11 cases). The overall MCH failure rate was 6.3% (11 of 174).
  
  
  CONCLUSIONS
  MCH appears more reliable than colposcopy and is capable of showing lesions undetectable by colposcopy.
authors.affiliation: Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Dexeus
authors.forename: R
authors.initials: R
authors.lastname: Labastida
authors.forename: A
authors.initials: A
authors.lastname: Ubeda