SHOULD ENDOCERVICAL EXCISION AND CURETTAGE BE DONE DURING LEEP

Objective To evaluate the need for routine endocervical sampling and e ndocervical curettage at the time of loop electrosurgical procedure (L EEP) in patients with satisfactory colposcopic assessment being treate d for dysplasia. Study Methods One hundred and eight patients having a satisfactory colposcopy referred for excision of their dysplasia with LEEP (four case) were studied. The procedure was carried out with a s tandard ectocervical excision to a depth of 6 mm and an endocervical e xcision centrally to a further 3 mm. An endocervical curettage was per formed at the end of the procedure. Results Of the 108 patients, 94 (8 7%) had a negative endocervical excision and endocervical curettage. T hirteen percent had a positive endocervical excision or endocervical c urettage. Only 2 patients had endocervical pathology worse than the ec tocervical pathology. There was no difference in the distribution of C IN I to CIN III in patients who had a negative endocervical excision o r a positive endocervical excision. In the overall group, complication s arose in 2.7% of patients and were minor and self-limiting. The over all long-term follow-up cure rate was 99% in the entire group. Conclus ions Satisfactory colposcopy is not an adequate discriminant for the u se of an ectocervical excision only for patients with dysplasia. Thirt een percent of patients would theoretically have had persistent diseas e if an endocervical excision was not performed. Adequate endo- and ec tocervical excisions are an important component of the LEEP procedure and cannot be separated.