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Beniwal S, Makkar B, Batra S, et al. Comparison of Vaginal versus Oral Estradiol Administration in Improving the Visualization of Transformation Zone (TZ) during Colposcopy. J Clin Diagn Res. 2016;10(7):QC18-21doi: 10.7860/JCDR/2016/19492.8201.
Beniwal, S., Makkar, B., Batra, S., Gandhi, G., Goswami, D., & Zutshi, V. (2016). Comparison of Vaginal versus Oral Estradiol Administration in Improving the Visualization of Transformation Zone (TZ) during Colposcopy. Journal of clinical and diagnostic research : JCDR, 10(7), QC18-21. https://doi.org/10.7860/JCDR/2016/19492.8201
Beniwal, Seema, et al. "Comparison of Vaginal versus Oral Estradiol Administration in Improving the Visualization of Transformation Zone (TZ) during Colposcopy." Journal of clinical and diagnostic research : JCDR vol. 10,7 (2016): QC18-21. doi: https://doi.org/10.7860/JCDR/2016/19492.8201
Beniwal S, Makkar B, Batra S, Gandhi G, Goswami D, Zutshi V. Comparison of Vaginal versus Oral Estradiol Administration in Improving the Visualization of Transformation Zone (TZ) during Colposcopy. J Clin Diagn Res. 2016 Jul;10(7):QC18-21. doi: 10.7860/JCDR/2016/19492.8201. Epub 2016 Jul 01. PMID: 27630912; PMCID: PMC5020212.
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J Clin Diagn Res. 2016 Jul;10(7):QC18-21. doi: 10.7860/JCDR/2016/19492.8201. Epub 2016 Jul 01.

Comparison of Vaginal versus Oral Estradiol Administration in Improving the Visualization of Transformation Zone (TZ) during Colposcopy.

Journal of clinical and diagnostic research : JCDR

Seema Beniwal, Binni Makkar, Swaraj Batra, Gauri Gandhi, Deepti Goswami, Vijay Zutshi

Affiliations

  1. Consultant, Karan Hospital , Bijnour, Uttarpradesh, India .
  2. Clinical Associate, Fortis Hospital , Shalimar Bagh, New Delhi, India .
  3. Head of Department, Department of Obstetrics and Gynaecology, Hamdard Institute of Research and Medical Sciences , New Delhi, India .
  4. Professor, Department of Obstetrics and Gynaecology, Maulana Azad Medical College , New Delhi, India .
  5. Senior Specialist, Department of Obstetrics and Gynaecology, Safdarjung Hospital , New Delhi, India .

PMID: 27630912 PMCID: PMC5020212 DOI: 10.7860/JCDR/2016/19492.8201

Abstract

INTRODUCTION: Colposcopy is an important diagnostic tool in the evaluation of patients with abnormal pap smears. However, in 10-20% transformation zone (TZ)/squamo-columnar junction is not completely visualized and these patients are deemed to have an incomplete colposcopy examination. Such patients usually require conization, a procedure associated with significant morbidity. Various agents like misoprostol, estrogens and laminaria tents have been used in the past to overcome the non-visualization of TZ.

AIM: The present study was conducted with the aim to compare the efficacy of vaginal versus oral estradiol administration in overcoming incomplete colposcopy.

MATERIALS AND METHODS: Forty patients with non/partially visualized TZ during colposcopy were recruited for the study. These patients were randomly distributed into two groups: In Group I, 25μg estradiol was administered intravaginally daily for seven consecutive days followed by a repeat colposcopy on day 8. In Group II, a seven day course of 25μg oral estradiol was followed by a repeat colposcopy on day 8. The efficacy of the two regimens in improving visualization of the TZ on colposcopy and their adverse effect profile was compared.

RESULTS: Vaginal estradiol had an overall efficacy of 70% in improving visualization of the TZ as compared to oral estradiol which was effective in 50% of patients (p-value-0.19). Major adverse effects in both the group of patients were nausea and vaginal discharge with no significant differences among the two groups.

CONCLUSION: Both vaginal and oral estrogens had comparable efficacy and similar adverse effect profile in improving visualization of the TZ.

Keywords: Cervical cancer; Estrogens; Squamo-columnar junction

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