TREATMENT OF CERVICAL DYSPLASIA WITH LARGE LOOP EXCISION OF THE TRANSFORMATION ZONE - IS ENDOCERVICAL CURETTAGE NECESSARY

Endocervical curettage (ECC) is done during most colposcopic examinati ons. To evaluate the need for routine ECC, we reviewed the records of all new patients seen in the colposcopy clinic at our institution from July 15, 1992, to April 15, 1993. During the study period. ECC was do ne in 341 patients with an adequate colposcopy. Only one case of mild dysplasia was discovered after ECC in the 123 patients referred for ev aluation of cervical intraepithelial neoplasia (CIN) I or atypia seen on Pap smear. ECC specimens were positive for dysplastic cells in only 3 of 203 patients (1.4%) in whom biopsy revealed CIN I or atypia, and Pap smears for all 3 patients were suggestive of more severe lesions. Routine ECC during the initial colposcopic examination adds expense a nd may cause significant patient discomfort. ECC can be safely omitted in patients with CIN I on referral Pap smear and before large loop ex cision of the transformation zone for treatment of more severe lesions .