[Current indications for colposcopic examination].

Abstract

OBJECTIVE: It has become necessary to set out exactly the indications for colposcopic examination and to improve out-patient therapy. A response has been made to the ever increasing pre-cancerous pathological conditions of the lower genital tract. TYPE OF STUDY: A review of the pathological conditions of the lower genital tract has led to colposcopic examinations being carried out to work out how far grounded its indications are. The authors particularly lead to the future for colposcopy and histology of so called "atypical" cytology. MATERIAL: A review of the literature and a retrospective study of the agreement between the cytology and the histology in 1,454 patients who were examined and followed up at the centre for laparoscopy and colposcopy between 1.1.1987 and 31.12.1991. THE PRINCIPLE: A study of the information is being gathered about the cytological, colposcopic and histological diagnoses. PRINCIPLES RESULTS: Dysplasias diagnosed cytologically were confirmed in 95% of cases by colposcopic examination and by the results of directed biopsy. In over 90% cases of smears showing "atypical" cells the colposcopy confirmed the pathology that was found and in more than 85% of cases the histological examination confirmed a papillomavirus lesion or a dysplasia of the cervix or elsewhere in the lower genital tract. CONCLUSION: Over and above the indication for colposcopic examination, cytological dysplasias were found and to were condylomata of the lower genital tract or leukoplakia of the vulva, and one has to add "atypical" smears. Furthermore repeating a smear in cases of atypical cytology is useless, and can be deceptive. Systemic control of the vulva and vagina has to be carried out when the cervix is examined because there is a frequent association of dysplasic lesions and there is a possible presence of isolated extracervical lesions when cytologically pathological smears are found.