Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg

South African Family Practice

Field Value
Title Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg
Creator Mbuyisa, Sanele S. Khumalo, Thandekile L. Makhathini, Bongumusa S. Moodley, Jagidesa
Subject Gynaecology; primary care; primary health care cervical intraepithelial neoplasia; recurrence rates; simple hysterectomy; vaginal intraepithelial neoplasia; vain
Description Background: A simple hysterectomy is considered the definitive treatment modality for cervical intraepithelial neoplasia (CIN). However, it is associated with recurrence of vaginal intraepithelial neoplasia (VAIN) of up to 7.4%. We sought to determine recurrence rates of VAIN, in women living with HIV (WLWH) and non-infected women.Methods: This was a descriptive retrospective review of patients who received a simple hysterectomy for CIN between January 2015 and December 2017 in Pietermaritzburg.Results: Fifty-eight files were reviewed. Forty-two (72.4%) WLWH were seen; amongst those, 76.2% were virally suppressed. Abnormal vault cytology was only seen in patients with CIN grades 2 and 3. The recurrence rates for high-grade squamous intraepithelial lesion (HSIL) were 6.1% and 5.0% at 6 and 12 months, respectively. Human immunodeficiency virus co-infection was associated with 26.2% versus 13.3% of abnormal vault cytology compared to the HIV-negative counterparts (p = 0.164). Virologically suppressed patients had more abnormal cytology (28.1% vs. 0%) compared to the unsuppressed patients. There was a 17.2% and 65.5% loss- to follow-up rates at 6 and 12 months, respectively. Recurrence of premalignant lesions was noted amongst those who had the abdominal approach.Conclusion: The recurrence rates were comparable to the previous literature. A 6-month cytology follow-up showed no added benefit. Human immunodeficiency virus co-infection didn’t show a statistical significance on the recurrence rates; however, more structured studies are required to address this. Primary health care-based post operative surveillance can be a solution to address high loss to follow-up.
Publisher AOSIS
Contributor N/A
Date 2022-03-31
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Peer-reviewed Article Qualitative research
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v64i1.5457
Source South African Family Practice; Vol 64, No 1 (2022): Part 2; 5 pages 2078-6204 2078-6190
Language eng
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Coverage South Africa; KwaZulu-Natal; Pietermaritzburg; Umgungundlovu District January 2015- December 2017 Females; over 18 years of age; all races
Rights Copyright (c) 2022 Sanele Sidwell Mbuyisa