Tehran University Medical Journal

Background: Cervical cancer is one of the most common cancers in women.Conization of the cervix is one of the best diagnostic and therapeutic modality in preinvasive lesion of the cervix.

Methods: In this retrospective study we have evaluated the indications,complications, cytopathologic results, diagnostic and therapeutic value of 44 patients who underwent cervical conization.

Results: Age of the study group ranged from 18 to 75 (mean=43.18, SD=±11.4), and their parity ranged from 0 to 10 (mean 4-5, SD=±2-3). Ten cases (22.7%) were menopauses. The main indication was inability to visualize the entire T.zone (19 cases/43.2%) that was more prevalent in menopauses (50%/5cases in menopauses and 41.2% /14 cases in premenopauses). Bleeding occurred in 2 cases (4.5%) and urinary infection in 1 case (2.3%). The most common histologic result after conization was mild dysplasia in 23 cases (52.3%). The most common colposcopic biopsy result was moderate dysplasia in 16 cases (36.4%).The most common pap smear result was HSIL in 16 cases (36.4%). Two cases (4.5%) had invasive cancer in colposcopic- biopsy: one of them had ASCUS in the pap and another one had HSIL. Four cases (9.1%) had invasive cancer in histologic report: one of which had ASCUS on the pap and the others had HSIL.

Conclusion: Pap smear in screening of cervical cancer are not reliable and colposcopy is more acceptable in LSIL and ASCUS. Gynecologists should develop the skill to perform an accurate knife conization because the classical indications for conization continue to be valid and it has a low complication rate.