After-effects reported by women following colposcopy, cervical biopsies and LLETZ : results from the TOMBOLA trial
The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group (Including:). (2009) After-effects reported by women following colposcopy, cervical biopsies and LLETZ : results from the TOMBOLA trial. BJOG: An International Journal of Obstetrics & Gynaecology, Vol.116 (No.11). pp. 1506-1514. ISSN 1470-0328 Full text not available from this repository.
Official URL: http://dx.doi.org/10.1111/j.1471-0528.2009.02263.x
Objective Few studies have investigated physical after-effects of colposcopy. We compared post-colposcopy self-reported pain, bleeding, discharge and menstrual changes in women who underwent: colposcopic examination only; cervical punch biopsies; and large loop excision of the transformation zone (LLETZ).
Design Observational study nested within a randomised controlled trial.
Setting Grampian, Tayside and Nottingham.
Population Nine hundred-and-twenty-nine women, aged 20–59, with low-grade cytology, who had completed their initial colposcopic management.
Methods Women completed questionnaires on after-effects at approximately 6-weeks, and on menstruation at 4-months, post-colposcopy.
Main outcome measures Frequency of pain, bleeding, discharge; changes to first menstrual period post-colposcopy.
Results Seven hundred-and-fifty-one women (80%) completed the 6-week questionnaire. Of women who had only a colposcopic examination, 14–18% reported pain, bleeding or discharge. Around half of women who had biopsies only and two-thirds treated by LLETZ reported pain or discharge (biopsies: 53% pain, 46% discharge; LLETZ: 67% pain, 63% discharge). The frequency of bleeding was similar in the biopsy (79%) and LLETZ groups (87%). Women treated by LLETZ reported bleeding and discharge of significantly longer duration than other women. The duration of pain was similar across management groups. Forty-three percent of women managed by biopsies and 71% managed by LLETZ reported some change to their first period post-colposcopy, as did 29% who only had a colposcopic examination.
Conclusions Cervical punch biopsies and, especially, LLETZ carry a substantial risk of after-effects. After-effects are also reported by women managed solely by colposcopic examination. Ensuring that women are fully informed about after-effects may help to alleviate anxiety and provide reassurance, thereby minimising the harms of screening.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)|
|Divisions:||Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
|Journal or Publication Title:||BJOG: An International Journal of Obstetrics & Gynaecology|
|Publisher:||Wiley-Blackwell Publishing, Inc|
|Official Date:||October 2009|
|Page Range:||pp. 1506-1514|
|Access rights to Published version:||Restricted or Subscription Access|
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