title: Efficacy of Monsel Solution After Cervical Biopsy: A Randomized Trial.
abstract: OBJECTIVE
  To estimate the efficacy and side effects of Monsel solution for hemostasis after cervical punch biopsy.
  
  
  METHODS
  In a prospective, randomized trial, we compared application of Monsel solution versus a "wait and see" approach in women undergoing cervical punch biopsies in a 1:1 ratio. The primary end point was vaginal bleeding (VB) after 15 minutes measured by scoring a sanitary pad with a 5-level pictogram. Secondary end points were VB after 3, 6, and 24 hours (5-level pictogram), subjective estimation of overall VB during 24 hours, pain after 15 minutes and subjective estimation of overall pain after 24 hours, and overall satisfaction after 24 hours (11-level visual analogue scale).
  
  
  RESULTS
  One hundred forty-five women were randomized between July 2015 and January 2016. Mean objective VB scores after 15 minutes in 75 women with Monsel solution were 1.2 ± 0.6 compared with 1.8 ± 1.0 in 70 women without Monsel solution (P < 0.001). The secondary end points VB after 3 and 6 hours, but not after 24 hours, were also in favor of Monsel solution (2.1 ± 1.1 vs 2.9 ± 1.2; P < 0.001; 1.6 ± 0.7 vs 2.2 ± 1.0; P < 0.001; 1.6 ± 0.9 vs 1.7 ± 0.9; P = 0.4, respectively). Subjective estimation of overall VB during 24 hours was lower for Monsel solution (23.2 ± 15.8 vs 35.9 ± 19.5; P < 0.001), but pain after 15 minutes, overall pain, and overall satisfaction were not significantly different between groups (19.2 ± 14.4 vs 17.9 ± 16.2; P = 0.3; 20.7 ± 15.8 vs 20.1 ± 18.0; P = 0.5; and 44.1 ± 21.5 vs 43.6 ± 23.2; P = 0.9, respectively).
  
  
  CONCLUSIONS
  Application of Monsel solution significantly reduces bleeding for 6 hours after cervical biopsy but does not affect overall pain or overall satisfaction.
authors.affiliation: 1Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum; 2Institute of Pathology, Heinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany; and 3Department of Obstetrics and Gynecology, Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Hilal
authors.forename: Günther A
authors.initials: GA
authors.lastname: Rezniczek
authors.forename: Zena
authors.initials: Z
authors.lastname: Tettenborn
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Hefler
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy*; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012996:Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D012996:Solutions