Is there a role for cervicography in the detection of premalignant lesions of the cervix uteri?

The characteristics of cervicography and the Papanicolaou smear test have been compared for the detection of cervix lesions classified as CIN I or more. A total of 4,015 women were entered into the study. The sensitivity of cervicography is significantly higher (McNemar test, P < 0.0001), but its specificity remains significantly lower (McNemar test, P < 0.0001), and its higher sensitivity does not apply to lesions classified as CIN II or more (high-grade lesions). Hence, if patients with a positive screen result are to be referred for colposcopy-biopsy, cervicography is not a suitable alternative to the smear test for the screening of cervical cancer. However, cervicography can be envisaged as a complementary tool to the smear test because of (a) its higher capability to detect high-grade lesions among women less than 35 years old and (b) its potential superiority in following low-grade lesions. It may also serve as a tool for quality assurance audit of the smear test

Pudendal nerve decompression in perineology : a case series

BACKGROUND: Perineodynia (vulvodynia, perineal pain, proctalgia), anal and urinary incontinence are the main symptoms of the pudendal canal syndrome (PCS) or entrapment of the pudendal nerve. The first aim of this study was to evaluate the effect of bilateral pudendal nerve decompression (PND) on the symptoms of the PCS, on three clinical signs (abnormal sensibility, painful Alcock's canal, painful "skin rolling test") and on two neurophysiological tests: electromyography (EMG) and pudendal nerve terminal motor latencies (PNTML). The second aim was to study the clinical value of the aforementioned clinical signs in the diagnosis of PCS. METHODS: In this retrospective analysis, the studied sample comprised 74 female patients who underwent a bilateral PND between 1995 and 2002. To accomplish the first aim, the patients sample was compared before and at least one year after surgery by means of descriptive statistics and hypothesis testing. The second aim was achieved by means of a statistical comparison between the patient's group before the operation and a control group of 82 women without any of the following signs: prolapse, anal incontinence, perineodynia, dyschesia and history of pelvi-perineal surgery. RESULTS: When bilateral PND was the only procedure done to treat the symptoms, the cure rates of perineodynia, anal incontinence and urinary incontinence were 8/14, 4/5 and 3/5, respectively. The frequency of the three clinical signs was significantly reduced. There was a significant reduction of anal and perineal PNTML and a significant increase of anal richness on EMG. The Odd Ratio of the three clinical signs in the diagnosis of PCS was 16,97 (95% CI = 4,68 – 61,51). CONCLUSION: This study suggests that bilateral PND can treat perineodynia, anal and urinary incontinence. The three clinical signs of PCS seem to be efficient to suspect this diagnosis. There is a need for further studies to confirm these preliminary results

Instruments et techniques: quoi de neuf ?la cervicographie

SCOPUS: cp.jinfo:eu-repo/semantics/publishe

LA CERVICOGRAPHIE: LE COMPLEMENT DE LA CYTOLOGIE DANS LE DEPISTAGE DES LESIONS CERVICALES

SCOPUS: cp.jinfo:eu-repo/semantics/publishe

Intérêt du dépistage par cervicographie dans la pathologie dysplasique et néoplasique du col utérin.

In cervical dysplasia and neoplasia, recent studies have reported the unreliability of the pap smear. We have used a new screening technique, cervicography and have compared it to cervix cytology. We have performed biopsies under colposcopy as reference and quality control. On a series of 65 selected patients with pap smear screening program which were sent to the colposcopic triage, the cervicography is more sensitive (83%) than the pap smear (sensitivity: 42%). However, those two tests are from a specificity point of view, comparable (cervicography: 95% versus pap smear: 98%). The association of these two techniques has detected all the lesions: they seem to be complementary. In the Bordet Institute we decided to systematically perform both pap smear and cervicography for cervix screening.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

CORRELATION ENTRE CERVICOGRAPHIE ET CYTOLOGIE DANS LE DEPISTAGE DES LESIONS CERVICALES

SCOPUS: cp.jinfo:eu-repo/semantics/publishe