Complications of Loop Electrosurgical Excision Procedure Following Treatment of Cervical Intra-Epithelial Neoplasia 2 & 3

Abstract

Background: The loop electrosurgical excision procedure (LEEP) is currently one of the most commonly used approaches to treat high grade cervical squamus intraepithelial lesion confirmed on colposcopic guided biopsy examination. Complications of electrosurgical excision procedure (LEEP) are rare. But in Bangladesh, we have very limited research-based information regarding this issue. Aim of the Study: The aim of the study was to assess the complications of loop electrosurgical excision procedure following treatment of cervical intra-epithelial neoplasia (CIN) 2 and 3. Methods: This descriptive cross-sectional study was conducted in OPD, Gynaecology and Obstetrics Department, Rangpur Medical College Hospital, Rangpur, Bangladesh during the period of July 2011 to June 2012. In total, 75 patients with CIN 2 and/or 3 were enrolled in this study as study subjects. The study was approved by the ethical committee of the mentioned hospital. Proper informed written consents were taken from all the participants before data collection. The criteria for inclusion were colposcopic guided biopsy revealing CIN 2 or 3 whose lesion remains confined to ectocervix. The least amount of power that will effectively perform the electrosurgery should be used, so as to minimize the risk to the patient’s normal tissues and ensure that the excised specimen is inacceptable condition for pathological assessment. Data analysis was done by using statistical package for social science (SPSS) 16 versions. Results: In analyzing the post procedure complications of the participants, we observed that, 64% participants were from vaginal discharge. Besides this 21%, 9%, 4% and 1% cases were found with pain, bleeding, fever and cervical stenosis consequently. Distributing persistence of vaginal discharge, 44% participants taken 5-10 days which was noticeable. Only 5.33% participants had vaginal discharge in between 21-25 days. In distributing persistence of pain, we observed that, 8% participants had taken 30 days to be cured which was the highest number of patients. Within one week, all the patients become free from fever. Cervical Stenosis occurred as a delayed complication during follow up at 9-12 months after LEEP in only 1(1.3%) case and occurred at 270th day. Conclusion: As per the findings of this study we can mention vaginal discharge as the most common complication for the cervical intra-epithelial neoplasia patients by treating loop electrosurgical excision procedure. Besides these, physicians should be aware about the sufferings of patients from pain and bleeding. Finally, we can conclude that, LEEP as an easy safe and acceptable treatment for high grade CIN with high cure rate.