SYNTHETIC HYGROSCOPIC CERVICAL DILATOR USE IN PATIENTS WITH UNSATISFACTORY COLPOSCOPY

Objective: To assess the ability of a synthetic hygroscopic cervical d ilator to make an unsatisfactory colposcopic examination satisfactory, thereby avoiding cervical conization. Materials: From April 1991 to M arch 1993, 30 women with unsatisfactory colposcopic examinations under went repeat colposcopy after a synthetic hygroscopic cervical dilator had been placed in the endocervical canal for approximately 2 hours. R esults: The reasons for initial unsatisfactory colposcopy in the 30 pa tients were squamocolumnar junction not seen in its entirety (18 patie nts, 60%), lesion not seen in its entirety (ten, 33%), and neither tra nsformation zone nor lesion seen in their entirety (two, 7%). Complica tions were encountered in one patient from whom the dilator could not be removed completely. Of 29 patients undergoing repeat colposcopy, 23 (79%) had satisfactory examinations. In 15 of 30 patients, conization was avoided; it was required in six of 30 (20%) women for persistent unsatisfactory colposcopy (including the patient in whom the dilator b roke) and in nine of 30 (30%) for other indications. Conclusion: This experience suggests that a synthetic hygroscopic cervical dilator can be used in patients with an unsatisfactory colposcopy to achieve a sat isfactory examination, thus avoiding cervical conization.