Absent endocervical cells on Pap smears after loop electrosurgical excision procedure

To evaluate the absence of endocervical cells on Pap smear after loop electrosurgical excision procedure (LEEP) as a possible marker for cervical stenosis.

All LEEPs performed at a public health teaching hospital caring for the indigent between July 1, 1999, and September 30, 2002, were reviewed; 1,190 eligible charts of patients were reviewed, and extracted data included the following: age, parity, ethnicity, histology obtained during colposcopy, volume of loop specimen taken, and follow-up Pap smear results.

One thousand four hundred twenty-one patients had LEEPs during this period. One thousand one hundred ninety first follow-up Pap smears were evaluated; 200 patients had no follow-up Pap smears. The baseline background rate for absent endocervical cells was 7% for the general population. The study showed that the rate of absent endocervical cells on first follow-up Pap smears was 13.64% (173/1,193) (p = .03). The mean age of patients was 33.6 years; 11% (20/1,193) were aged older than 50 years. There was no significant difference with age and parity in the stenosis versus nonstenosis group.

The LEEP was significantly associated with absent endocervical cells on follow-up Pap smears, which may be indicative of cervical stenosis.