An analysis of the outcomes of cervical cone biopsies performed in a low resource setting

Following skills transfer to this low resource setting, we carried out a descriptive analysis of the outcomes of all cone biopsies performed for women with cervical intra-epithelial neoplasia 3 (CIN 3). We also compared two methods of cone biopsy. All the women had follow-up smear tests at 6 and 18 months. There were no cases of CIN 3 at follow-up. 80% had normal smears at 18 months and 20% had CIN 1. Compared with knife cone biopsy, women who had an electric knife (hand-held diathermy blade) cone biopsy had a significantly smaller volume of mean blood loss (55.5mls ± 15.9 vs 153.3ml ± 40, p < 0.001). With appropriate skills transfer, women with CIN 3 in a low resource setting can be effectively treated with conisation procedures. The diathermy knife is preferred to cold knife because of its associated low blood loss.