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Published on: December 15, 2008
Electrofulguration for low-grade squamous intraepithelial lesions of the cervix (CIN 1)
Marie-Christine Roy1, Marie-Hélène Mayrand, Eduardo Franco
1Department of Obstetrics & Gynecology, Centre Hospitalier Université Laval, Quebec, Canada.
Objectives:
To evaluate the therapeutic efficacy and adverse events of electrofulguration for the treatment of cervical intraepithelial lesion grade 1 (CIN 1).
Materials And Methods:
Women aged 19 years and older received electrofulguration for histologically proven exocervical CIN 1. They were followed up at 3, 6, and 12 months with cytologic analysis, colposcopy, and, when indicated, histologic examination. Therapeutic success was defined as absence of disease at 12 months after therapy. Adverse effects were recorded during and after the procedure.
Results:
Of 78 women treated, 32 (41.0%) were lost to follow-up and 6 patients (7.7%) were retreated. Using intent-to-treat definition including patients lost to follow-up, 40 of 78 (52.6%) were free of disease at the 1-year follow-up visit. Excluding patients lost to follow-up, cure rates were 87% (40/46) and 100% (40/40) after single and repeat treatment, respectively. Adverse effects included mild to moderate discomfort (78%), intermittent spotting (70%), and pelvic pain (44%). The procedure lasted 2 minutes in 83% of cases and was easy to perform.
Conclusions:
Electrofulguration under local anesthesia is an attractive ablative treatment method for exocervical CIN 1 and compares favorably with cryocoagulation as per review of the literature.
