scholarly journals A Case Report: Conservative Treatment Modalities as Loop Electrosurgical Excision Procedure (LEEP) Can Be Used to Treat Precancer Cervix Lesion High Grade Squamous Intraepithelial Lesion (HSIL) or Moderate and Severe Dysplasia (CIN II and III) with Post Coital Bleeding Disorders

Author(s):  
Dr. Supriyono
2021 ◽  
Vol 8 ◽  
Author(s):  
Jun Ding ◽  
Haiou Xu ◽  
Lihua Xia ◽  
Shanshan Cao ◽  
Qing Wu

Objectives: To compare the performance and outcomes of monopolar electrosurgical conization (MESC) or the loop electrosurgical excision procedure (LEEP) in the treatment of high-grade squamous intraepithelial lesion (HSIL).Methods: This retrospective study included 554 patients diagnosed with HSIL through biopsy. The study used either LEEP or MESC for cervical conization. Additionally, the medical records of these patients, including the basic information, status of the excision margin, cone depth, cone width, fragmentation, complication, and the results of a 6-month follow-up after conization, were reviewed.Results: Compared to MESC, LEEP had a significantly higher rate of positive endocervical margin (3.77 vs. 8.65%; p = 0.018), burn injury of the margin (4.90 vs. 10.38%; p = 0.016) and a lower rate of adequate cone depth (83.40 vs. 89.62%; p = 0.034). In addition, LEEP was significantly more likely to cause fragmentation (p = 0.000). There was, however, no significant difference in the rate of abnormal cervical cytology and positive high-risk HPV (hrHPV) between these two groups, 6 months after cervical conization.Conclusion: Both LEEP and MESC appeared to be equally effective in the clinical treatment of HSIL. Nonetheless, MESC resulted in a better pathological outcome with regard to the status of the margin, tissue fragmentation, and cone depth.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2090454
Author(s):  
Darosa Lim ◽  
Annie Belisle ◽  
Deana Funaro

High-grade squamous intraepithelial lesion of the vulva is a premalignant condition which may be especially resistant to treatments among immunosuppressed patients. We present our experience with the use of topical cidofovir in a refractory case of extensive vulvar high-grade squamous intraepithelial lesion in a 37-year-old transplant patient. Eighteen cycles of cidofovir over a 2-year period led to a sustained significant improvement, mainly of the mucosal lesions and was well tolerated. To our knowledge, we have not seen this therapy described in transplant patients with extensive high-grade squamous intraepithelial lesion.


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