Colposcopy Guided Management of Cervical Erosions in Rural Population

Cervical erosion, a common gynaecological finding,either has inflammatory or neoplastic origin. Colposcopy and guided biopsy help in differentiating inflammatory lesions from neoplastic lesions. The objectives were to study various colposcopic findings in cervical erosions, to co-relate colposcopy findings with histopathology of cervical biopsy and to find out the outcome of different treatment modalities for cervical erosion. A prospective observational study of 100 cases of cervical erosion diagnosed during gynaecological examination in outpatient department over a period of two years .All cases were subjected to colposcopy .Colposcopy guided biopsy was taken in cases with abnormal colposcopy findings. The results of colposcopy and guided biopsy were compared. Sixty seven percent women revealed normal colposcopy findings .Thirty percent women revealed abnormal colposcopy findings such as aceto-white areas, abnormal vascular patterns (mosaic and Punctation) and iodine negative areas. Coppleson grading of colposcopic abnormalities revealed 5 cases in grade I, 17 cases in grade II and 8 cases in grade III. Histopatology of these 30 cases revealed CIN I and chronic cervicitis, cervical metaplasia with atypia in grade I, CIN II and chonic cervicitis in grade II and CIN III and invasive cancer in Grade III colposcopic abnormalities. Out of 100 cases of cervical erosions, 15 cases had pre-invasive neoplastic lesion (CIN) and 2 cases had invasive lesions (Stage 1B cancer cervix).Premalignant lesions were treated with cryotherapy or hysterectomy and invasive lesions were treated with radical hysterectomy. Colposcopy and histopathology play complimentary role in diagnosis and management of cervical erosions.