Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg
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 H...
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AOSIS
2022-03-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/5457 |
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| author | Sanele S. Mbuyisa Thandekile L. Khumalo Bongumusa S. Makhathini Jagidesa Moodley |
| author_facet | Sanele S. Mbuyisa Thandekile L. Khumalo Bongumusa S. Makhathini Jagidesa Moodley |
| author_sort | Sanele S. Mbuyisa |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-8d97fe1a64d048caabd9bf0700de9faa |
| institution | DOAJ |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | AOSIS |
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| series | South African Family Practice |
| spelling | doaj-art-8d97fe1a64d048caabd9bf0700de9faa2025-08-20T03:06:51ZengAOSISSouth African Family Practice2078-61902078-62042022-03-01641e1e510.4102/safp.v64i1.54574219Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, PietermaritzburgSanele S. Mbuyisa0Thandekile L. Khumalo1Bongumusa S. Makhathini2Jagidesa Moodley3Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Grey’s Hospital, University of KwaZulu-Natal, PietermaritzburgDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Edendale Regional Hospital, University of KwaZulu-Natal, DurbanDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Grey’s Hospital, University of KwaZulu-Natal, PietermaritzburgDepartment of Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu-Natal, DurbanBackground: 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.https://safpj.co.za/index.php/safpj/article/view/5457cervical intraepithelial neoplasiarecurrence ratessimple hysterectomyvaginal intraepithelial neoplasiavain |
| spellingShingle | Sanele S. Mbuyisa Thandekile L. Khumalo Bongumusa S. Makhathini Jagidesa Moodley Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg South African Family Practice cervical intraepithelial neoplasia recurrence rates simple hysterectomy vaginal intraepithelial neoplasia vain |
| title | Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg |
| title_full | Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg |
| title_fullStr | Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg |
| title_full_unstemmed | Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg |
| title_short | Prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia, Pietermaritzburg |
| title_sort | prevalance of abnormal vault cytology after hysterectomy for cervical intraepithelial neoplasia pietermaritzburg |
| topic | cervical intraepithelial neoplasia recurrence rates simple hysterectomy vaginal intraepithelial neoplasia vain |
| url | https://safpj.co.za/index.php/safpj/article/view/5457 |
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