Image assessment of cervical dimensions after LLETZ: a prospective observational study. Issue 4 (11th December 2012)

• Record Type: Journal Article
• Authors: Carcopino, X; Maycock, JA; Mancini, J; Jeffers, M; Farrar, K; Martin, M; Khalid, S; Prendiville, W
• Is Part Of: BJOG. Volume 120:Issue 4(2013:Apr.)
• Page Start: 472
• Page End: 478
• Publication Date: 2012-12-11
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12105
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" xml:lang="en" id="bjo12105-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12105-sec-0001" sec-type="section"> <title>Objective</title> <p>To assess the impact of large loop excision of the transformation zone (LLETZ) for cervical intraepithelial neoplasia (CIN) on cervical morphology as assessed by three‐dimensional ultrasound.</p> </sec> <sec id="bjo12105-sec-0002" sec-type="section"> <title>Design</title> <p>Prospective observational study.</p> </sec> <sec id="bjo12105-sec-0003" sec-type="section"> <title>Setting</title> <p>University Hospital in Dublin.</p> </sec> <sec id="bjo12105-sec-0004" sec-type="section"> <title>Population</title> <p>Women with CIN who underwent an LLETZ procedure.</p> </sec> <sec id="bjo12105-sec-0005" sec-type="section"> <title>Methods</title> <p>All 106 participants had a three‐dimensional transvaginal ultrasound scan (3DTVS) performed immediately before and 6 months after LLETZ. The excised LLETZ specimen dimensions were also recorded. Blind analysis of the images was performed. The volume of the uterus and cervix was documented.</p> </sec> <sec id="bjo12105-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>The relationship between the extirpated LLETZ dimensions and subsequent cervical and uterine biometry, as assessed by 3DTVS.</p> </sec> <sec id="bjo12105-sec-0007" sec-type="section"> <title>Results</title> <p>LLETZ induced a statistically significant reduction in both the length (mean, –0.46 cm; <italic>P </italic>< 0.001) and the volume (–6.12 cm<sup>3</sup>; <italic>P </italic>< 0.001) of the uterus, and in the volume of the cervix (–1.60 cm<sup>3</sup>; <italic>P </italic>< 0.001). The volume of the excised specimen had a significant impact on the reduction of the length of the uterus (β, –0.038; <italic>P </italic>= 0.012), the volume of the uterus (β, –0.791; <italic>P </italic>= 0.036) and the volume of the cervix (β, –0.121; <italic>P </italic>= 0.046). The circumference of the excised specimen appeared to have a significant impact on the length (β, –0.016; 95% CI, –0.028 to –0.003; <italic>P </italic>= 0.013) and volume (β, –0.413; 95% CI, –0.719 to –0.107; <italic>P </italic>= 0.009) of the uterus 6 months after LLETZ.</p> </sec> <sec id="bjo12105-sec-0008" sec-type="section"> <title>Conclusions</title> <p>The volume of tissue removed at LLETZ is related to the subsequent cervical volume, as well as the uterine length and volume, 6 months after the procedure.</p> </sec> </abstract>