Does microcolposcopy protect patients with CIN and unsatisfactory colposcopy from the risk of incomplete excision of disease at the time of conization?

Abstract

Objective: To evaluate the effectiveness of microcolposcopy in preventing incomplete electrosurgical excision at the endocervical cone margin in patients with CIN and unsatisfactory colposcopy.

Materials and methods: Four-hundred and twenty-one patients were studied. Complete excision of disease at the endocervical margin was evaluated using multiple logistic regression analysis.

Results: One-hundred and eighty-three patients underwent microcolposcopy. In 160 patients, the cone depth exceeded the endocervical extension of the squamocolumnar junction as predicted by microcolposcopy. In 23 patients, the opposite was observed. Microcolposcopy was not performed in 238 patients. For the three groups, the frequency of endocervical cone margin involvement was 22%, 22%, and 13%, respectively. Multiple logistic regression analysis showed that patients with a cone depth exceeding the endocervical margin of the squamocolumnar junction as predicted by microcolposcopy had no reduction in the risk of incomplete conization.

Conclusion: The use of microcolposcopy awaits validation for assessment of the transformation zone to predict negative conization margins.