Objectives To compare two methods of hemostasis after loop electrosurgical excision procedure (LEEP), with and without vaginal pack.
Methods A randomized clinical trial was performed at Barretos Cancer Hospital (BCH) from October 2014 to June 2015 with 100 patients that underwent LEEP of the cervix, randomized to insert a vaginal pack (VP) or to not insert it (WVP) after the procedure. The primary outcome was postoperative gynecologic intervention due to vaginal bleeding after procedure. The secondary was number of days with vaginal bleeding. Only the participants were blinded to group assignment. Categorical variables were compared using a chi-square test or the Fisher exact test and used 5% of significance level.
Results Hormonal status, previous pregnancies and histological results were well distributed between the groups. Postoperative abnormal vaginal bleeding requiring intervention had no statistical difference between VP and WVP patients group (p=0.3074) as other complications as well (table 1). Median of related days of vaginal bleeding after the procedure were 7.4 days (SD 8.75) in VP group and 7.34days (SD 8.52) in WVP group, with no statistical difference (p=0.912).
Conclusions Insert a vaginal pack or not, after LEEP, do not affect the number of postoperative gynecologic intervention due to vaginal bleeding or the amount of postoperative bleeding days. Previous pregnancies, hormonal status, cytology or LEEP specimen characteristics did not affect the disclosure. We also could not find any risk factor associated to abnormal bleeding. Based on that, the use of vaginal pack can be omitted with no further complications.
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