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Characteristics of a group of adolescents undergoing loop electrical excision procedure (LEEP).

Abstract：

STUDY OBJECTIVE:To describe the sociodemographic characteristics of a cohort of adolescents undergoing loop electrosurgical excision procedure (LEEP) of the cervix, and to determine if LEEP is a safe and effective procedure for evaluation and treatment of high-grade squamous intraepithelial lesions (HSIL) of the cervix in adolescents. SETTING:Case series of all adolescents who underwent LEEP between 1995 and 1997 at Children's Hospital, Boston, MA. DESIGN:Medical and laboratory records were reviewed to assess baseline characteristics and the following outcomes: (1) LEEP pathology results, (2) postoperative complications, (3) pregnancy outcomes, (4) compliance with follow-up appointments, and (5) recurrence of disease over a 12- to 37-month period. PARTICIPANTS:Thirty-five adolescents underwent LEEP. The mean age of the adolescents at the time of LEEP was 17.9 +/- 1.5 yrs. RESULTS:The mean interval between coitarche and LEEP was 3.69 +/- 2.09 yrs. On preoperative colposcopy, 28 (80%) had HSIL on biopsy, 3 (8.6%) had HSIL on Pap smear with a discordant biopsy demonstrating low-grade squamous intraepithelial lesion (LSIL), 1 (2.9%) had a persistent LSIL, 2 (5.6%) had diffuse LSIL with an unsatisfactory colposcopy, and 1 (2.9%) had a HSIL Pap smear with a normal biopsy. LEEP specimen histopathology results were: HSIL in 19 (54%), LSIL in 10 (29%), SIL difficult to grade in 3 (9%), and no residual disease in 3 (9.0%). Postoperative complications were bleeding in 2 (5.7%), pain in 1 (2.9%), vaginal discharge in 1 (2.9%), cervicitis in 3 (8.6%), and endometritis in 2 (5.7%). Fourteen pregnancies were diagnosed after LEEP; no spontaneous abortions occurred. Mean follow-up period was 21.1 +/- 9.4 months. Compliance with follow-up appointments was 51% in the first 12 months post-LEEP and 26% in the second 12 months post-LEEP. Of the 28 patients followed for 12 months or more, there was one recurrence of HSIL confirmed by colposcopy and biopsy. CONCLUSIONS:Outcome and complications of LEEP in adolescent females are similar to those reported in larger series of adult women. LEEP appears to be a safe and effective procedure for the evaluation and treatment of HSIL of the cervix in adolescents, but additional long-term data are needed.

journal_name

J Pediatr Adolesc Gynecol

journal_title

Journal of pediatric and adolescent gynecology

authors

Perlman SE,Lubianca JN,Kahn JA

doi

10.1016/s1083-3188(02)00209-7

subject

Has Abstract

pub_date

2003-02-01 00:00:00

pages

15-20

issue

eissn

1083-3188

issn

1873-4332

pii

S1083318802002097

journal_volume

pub_type

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Characteristics of a group of adolescents undergoing loop electrical excision procedure (LEEP).