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Médecine et Santé Tropicales

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Twelve months of colposcopy use at the Brazzaville University Hospital Gynecology Clinic Volume 22, issue 4, Octobre-Novembre-Décembre 2012

Authors
Service de gynécologie obstétrique, CHU de Brazzaville, Brazzaville, Congo, Service de maternité, hôpital de Talangaï, Brazzaville, Congo, Service d’histopathologie, CHU de Brazzaville, Brazzaville, Congo

Objective. To assess the utility of a colposcope after 12 months of use at the Brazzaville University Hospital. Patients and methods. This retrospective study took place in the gynecology unit of the Brazzaville University Hospital and reviewed records dating from January 11, 2010, through January 10, 2011. In all, 150 women (13.5% of all gynecology consultations) underwent colposcopies in the department, for one of two indications: diagnostic colposcopy after an abnormal cervical smear, 91 cases (60.7%), and primary colposcopy in women admitted without a cervical smear, 59 cases (39.3%). High-grade squamous intraepithelial lesions (HGILs) were noted in 36.7% of the cases; the colposcopy was normal in 17.3% of the cases, and squamous cell carcinoma was found in 8.6% of the cases. Colposcopy found HGILs on 14 smears of 24 cervical smears reporting low-grade squamous intraepithelial lesions (LGIL), six of seven initially reported as HGIL, and 10 of 20 initially reported as atypical squamous cells of undetermined significance (ASCUS) on 20. In all, 93 women (62%) had biopsies. Cervical intraepithelial neoplasia 2 (CIN2) lesions were noted on 19 of the 55 biopsies of HGIL colposcopies and CIN3 on four of the 55. Discussion. Colposcopy remains unavailable to too many women, largely because of the difficulty in obtaining a primary cervical smear tests. This also explains the overuse of primary colposcopy or, at least, the uncertainty about its role.