Risk of cervical stenosis after cervical excision in postmenopausal patients

Abstract

Objective

Cervical excision may cause cervical stenosis, leading to suboptimal follow-up of dysplasia and delayed diagnosis of cervical and endometrial pathology. This study aimed to quantify the risk of stenosis development after electrosurgical cervical excision in postmenopausal patients.

Methods

Retrospective cohort study based on data collection from electronic medical records and the Danish National Pathology Data Bank. Patients aged ≥45 years who underwent electrosurgical cervical excision in the Gynecological Department, at Randers Regional Hospital from1^st of January 2012 to 31st December 2019 were included. Primary outcome was risk of cervical stenosis following cervical excision.

Results

Of the 567 cervical excisions conducted within the study period, 300 patients (52.9 %) met the inclusion criteria. Among these, 79 postmenopausal patients (26.3 %) developed cervical stenosis after cervical excision. Patients with stenosis were significantly older (median 64 years) compared to those without stenosis (median 61 years) (p = 0.004). Patients aged >60 years at the time of cervical excision exhibited an increased risk of cervical stenosis (relative risk 1.51 (95 % confidence interval 1.08–2.18)) compared to those ≤60 years.

Conclusion

More than one in four postmenopausal patients experienced the development of cervical stenosis following cervical excision. Patients should be adequately informed of the possible risk of cervical stenosis development prior to undergoing diagnostic or therapeutic cervical excision procedure.