title: A comparison of colposcopy using optical and video colposcopes.
abstract: OBJECTIVE
  To compare the colposcopic adequacy, colposcopic impressions, histologic sampling intent, biopsy site location, procedural complications, and difficulty of colposcopic examinations using optical and video colposcopes.
  
  
  METHODS
  Women and men presenting consecutively for colposcopy were examined independently by two colposcopists using alternately either an optical or video colposcope. Colposcopists individually recorded their exam adequacy, colposcopic impression, biopsy intent and site, procedural complications, and difficulty of examination. Most colposcopists had no prior experience with video colposcopes.
  
  
  RESULTS
  Of 300 patients, mean age 35.3 years (±12.2 SD), examined, 29.7% were nulliparous, 4.9% pregnant, 52.5% had a previous biopsy and 34.3% had prior cervical treatment. Agreement between colposcopes was excellent for visualizing the complete squamocolumnar junction (75.6%, x = 6.40, p = 0.09). Colposcopists using the video colposcope had more unsatisfactory exams of the endocervical canal (36.6%, 97/265) than did colposcopists using optical colposcopes (24.9%, 66/265, x = 16.65, p = 0.001). Colposcopic impression agreement with pathology results were not significantly different between the video (58.1%) and optical (57.0%) colposcopes (x = 0.09, p = 0.8). Biopsy intent (79.9% agreement, x = 0.20, p = 0.7) and biopsy site selection by cervical quadrant were not significantly different for the two colposcopes. Both types of colposcopes were rated extremely easy to use, but colposcopy in general (T = 3.97, p < 0.001), visualization (T = 2.98, p = 0.002), assessment (T = 2.76, p = 0.004), and sampling (Wilcoxon = 2.27, p = 0.02) were determined to be easier when using optical colposcopes.
  
  
  CONCLUSIONS
  Video colposcopes have similar, clinically relevant outcomes when compared with optical colposcopes. Colposcopists using optical colposcopes reported easier colposcopy exams and fewer unsatisfactory examinations of the endocervical canal. These findings may represent a learning curve effect as colposcopists become familiar with operating the video colposcope.▪.
authors.affiliation: From the Departments of * Family Medicine, §Obstetrics and Gynecology, and ††Office of Biostatistics, Medical College of Georgia, Augusta, Georgia; †Department of Gynecologic Oncology and Urogynecology, KK Women and Children's Hospital, Singapore; ‡Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Canada; ∥Department of Gynecology, University of Sao Paulo, Sao Paulo, Brazil; ‡‡Department of Obstetrics and Gynecology, Bichat Claude Bernard Hospital, Paris, France; and the **Department of Obstetrics and Gynecology, Ninewells Hospital, University of Dundee, Dundee, Scotland.
authors.forename: D G
authors.initials: DG
authors.lastname: Ferris
authors.forename: T H
authors.initials: TH
authors.lastname: Ho
authors.forename: F
authors.initials: F
authors.lastname: Guijon
authors.forename: M S
authors.initials: MS
authors.lastname: Macfee
authors.forename: D M
authors.initials: DM
authors.lastname: Guerra
authors.forename: R
authors.initials: R
authors.lastname: Barrasso
authors.forename: I D
authors.initials: ID
authors.lastname: Duncan
authors.forename: M S
authors.initials: MS
authors.lastname: Litaker