Absent endocervical cells on Pap smears after loop electrosurgical excision procedure

Area of Science:

• Gynecology
• Cervical Pathology
• Cytopathology

Background:

• Loop electrosurgical excision procedure (LEEP) is a common treatment for cervical dysplasia.
• Cervical stenosis is a potential complication following LEEP.
• The presence of endocervical cells on Pap smears is an indicator of adequate sampling.

Purpose of the Study:

• To investigate whether the absence of endocervical cells on post-LEEP Pap smears can serve as a marker for cervical stenosis.
• To evaluate the association between LEEP and the rate of absent endocervical cells on follow-up Pap smears.

Main Methods:

• Retrospective review of 1,190 patient charts who underwent LEEP between 1999 and 2002.
• Data collected included patient demographics, colposcopy histology, LEEP specimen volume, and follow-up Pap smear results.
• Analysis focused on the rate of absent endocervical cells on the first follow-up Pap smear.

Main Results:

• The rate of absent endocervical cells on the first follow-up Pap smear after LEEP was 13.64%, significantly higher than the baseline rate of 7% (p = .03).
• No significant association was found between age or parity and the development of cervical stenosis.
• A total of 1,190 follow-up Pap smears were evaluated; 200 patients lacked follow-up.

Conclusions:

• Loop electrosurgical excision procedure (LEEP) is significantly associated with the absence of endocervical cells on subsequent Pap smears.
• The absence of endocervical cells following LEEP may be an indicator of cervical stenosis.