Işık KABAN, Hüseyin CENGİZ, LEVENT YAŞAR, MURAT EKİN, ESİN AVCI, Hakan GÜRASLAN

Postkoital kanama nedeni ile kolposkopi yapılan olguların değerlendirilmesi

Amaç: Postkoital kanama şikayetiyle başvuran olguların demografik ve klinik özelliklerinin, smear sonuçlarının, kolposkopik bulgularının ve biyopsi sonuçlarının ortaya konmasıdır. Materyal ve Metot: Ocak 2010-Ocak 2012 tarihleri arasında jinekoloji polikliniğine postkoital kanama şika-yeti ile başvuran ve servikal smear sonrası kolposkopik muayeneye yönlendirilen 67 premenopozal ve postme-nopozal hasta değerlendirmeye alındı. Tüm olgulara kolposkopik değerlendirme yapıldı ve gerekli olgulara kolposkopi eşliğinde biyopsi yapıldı. Olguların demografik özellikleri, servikal smear sonuçları, kolposkopik biyopsi raporlarından elde edilen bulgular SPSS 10 paket programı ile değerlendirildi. Bulgular: Ortalama yaş 37,61 olarak saptandı. Olguların çoğunluğu korunma yöntemi olarak coitus interraptus (geri çekme) ve rahim içi araç (RİA) kullanmakta (%31,3), sigara içmiyor (%64,2) ve multipariteye sahipti (%92,6). Önemi bilinmeyen atipik hücreler (ASC-US) smear değişikliği 6 (%9) olguda, düşük dereceli skuamöz intra-epitelyal lezyon (L-SIL) smear bulgusu 2 (%3) olguda izlenirken; yüksek dereceli skuamöz intraepitelyal lezyon HSIL 1 (%1,5) olguda tespit edildi. Kolposkopik biyop-side 47 (%74,6) hasta için servikal preinvazif/invaziv lezyonlar için negatif bulgular saptanmış olup; servikal intraepitelyal neoplazi-1 (CIN1) teşhisi konulan hasta sayısı 13 (%20,6), CIN2 teşhisi konulan hasta sayısı 1 (%1,6) ve CIN3 teşhisi konulan hasta sayısı 1 (%1,6)dir. Ayrıca kanser teşhisi konulan hasta sayısı ise 1 (%1,6)dir. Dört (%6) hastaya kolposkopik bulgular normal saptandığı için biyopsi yapılmamıştır. Sonuç: Postkoital kanama ile başvuran olgularda çoğun-lukla benign bulgular saptanmasına rağmen, yüksek dereceli CIN ve invaziv kanser insidansındaki artış nede-niyle kolposkopik olarak değerlendirme gerekmektedir.

Evaluating the outcome of colposcopy in women presenting with postcoital bleeding

Objective: To determine the demographic, clinical, cytologic, colposcopic findings and biopsy findings in women with postcoital bleeding Material and method: Sixty-seven premenopausal and postmenopausal women with postcoital bleeding were referred to colposcopy unit between January 2010 and January 2012. Colposcopic evaluation was performed in all cases and colposcopy-guided biopsy was performed when necessary. Demographic features, cervical cytology results, colposcopic diagnosis and biopsy reports of the cases were evaluated. Data were analyzed with SPSS 10.0 program. Results: The median age was 37.61. Most of the cases were found to use coitus interruptus and intrauterine device as a contraceptive method (31.3%) and were non-smoker (64.2%) and multiparous (92.6%). Cervical cytology identified 6 (%9) patients with ASCUS, 2 (3%) with LSIL and 1 (1.5%) with HSIL. Forty-seven (74.6%) patients had normal findings at colposcopic biopsy and 13 (20.6%) patients had CIN 1 at biopsy, 1 (1.6%) patient had CIN 2 and 1 (1.6%) patient had CIN 3 at colposcopic biopsy. One patient had invasive carcinoma (1.6%) according to histopathologic evaluation. Four (6%) patients did not receive biopsy due to normal colposcopic findings. Conclusion: Although, most of the cases with postcoital bleeding have benign lesions, colposcopy should be performed owing to the increased incidence of high grade CIN and invasive neoplasia.

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