Effects of ball cauterization following loop excision and follow-up colposcopy

Objective: To investigate whether central diathermy ball cauterization afte r loop excision affects satisfactory colposcopy at follow-up. Methods: One hundred one consecutive women with the squamocolumnar junction visible at the ectocervix scheduled for loop excision were assigned altern ately into two groups. In group A, diathermy ball cauterization was applied to the entire crater following excision. In group B, cauterization was avo ided in a 2-3-mm zone around the new os. The women were re-examined 4 month s postoperatively by colposcopy and microcolpohysteroscopy with specific in tention to identify the location of the squamocolumnar junction. The examin ers performing colposcopy and microcolpohysteroscopy were not aware of each other's interpretation, or of the method of cauterization used. Results: Follow-up colposcopy was satisfactory in 12 women in group A (24%) and 47 women in group B (92.2%) (P < .001). Forty-three women (86%) in gro up A and ten in group B (19.6%) had the squamocolumnar junction partly or f ully located within the cervical canal (P < .001). Microcolpohysteroscopy l ocated the squamocolumnar junction at a mean depth of 4.5 +/- 2.4 mm (+/-: standard deviation [SD]) in the women in group A and 1 +/- 0.9 mm in group B (P < .001). Microcolpohysteroscopy could not be performed in 13 women in group A (26%) and one woman in group B (2%) (P < .001). Conclusion: Diathermy ball cauterization at the new cervical os after loop excision results in a shift of the squamocolumnar junction toward the endoc ervical canal, and predisposes to cervical stenosis, thereby decreasing sat isfactory colposcopy rates. (C) 2001 by The American College of Obstetricia ns and Gynecologists.