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EP1068 CO2 Laser ablation for cervical intraepitelial neoplasia:retrospective study at ‘Ramón y Cajal’ University Hospital
  1. C del Valle Rubido1,
  2. C Martín Blanco1,
  3. M Salvador Osuna1,
  4. E Díaz González1,
  5. MC Sánchez Martínez1,
  6. E Cabezas López1,
  7. C Miguel Bayo2,
  8. B Pérez Mies3,
  9. E Moratalla Bartolomé1 and
  10. J Lázaro- Carrasco1
  1. 1Obstetrics and Gynecology
  2. 2Hospital Universitario Ramón y Cajal
  3. 3Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain


Introduction/Background CO2 ablation of cervical lesions is used for treatment of persitent CIN1 or CIN2/3 with adequate colposcopy. In our Department, laser ablation is performed under colposcopic guidance by specially trained clinicians.

Methodology We have performed a retrospective study of CIN that has been treated by laser ablative therapy at ‘Ramón y Cajal’ University Hospital from January 2018 to April 2019.

Results 51patients have undergone laser ablative therapy in the past 1,3years.

Mean age is 36,9years-old and parity is 0.54children per woman in the study group. The subject´s nationality is 62%Spanish, 23% from South America and 13% from Eastern Europe. 33%use condoms as contraceptive method, 29%oral contraceptives, 23,5%do not use any method, 3.9%IUD and only 1.9%vasectomy or vaginal ring. None of the patients are inmunodepressed. 37.2%are active smokers vs 49%non-smokers. Only 27%have received HVP vaccination. HPV infection is present in all but one patient: 55.9% high-risk HPV(not16 or18), 17%HPV16, 13.7% HPV16 and another high-risk HPV, 3.9%HPV18 and 1.9%HPV18 and another type.

Colpo-histologic study previous to ablation shows:

- Pap-smear: 47% LSIL, 19%ASCUS, 15.6%negative, 7.8%ASC-H and 7.8%HSIL.

- Colposcopy: 17.6%negative, 3.9%erithroplakia, G1 changes(19.6% mosaicism, 19.6%,19.6%acetowhite epithelium, 11.7%punctation), G2 changes (3.9%acetowhite epithelium,1.9%mosaicism, 1.9%punctation), 3.9%condyloma, 13.7%negative Schiller test and 1.9%insatisfactory colposcopy.

- Histology: 64.7%CIN1, 7.8%CIN2/3, 7.8%chronic cervicitis and 3.9%negative.

Indications for cervical ablation are: 58%persistent CIN 1, 11.7% CIN2/3, 3.9% postcoital bleeding and 1case persistent ASCUS.

At the moment, 25patients have undergone cervical ablation with laser CO2, 22 are pending and 3 have been lost. No complications have taken place.

14 patients have reached the 6-month follow-up visit, all of whom had negative results except 1ASCUS Pap-smear and 3LSIL (all arising in previous CIN2/3-HSIL). HPV has become negative in 6patients. Only one patient has required surgery because of persistent CIN2.

Conclusion Ablative treatment for cervical intraepitelial neoplasia appears to be effective, with low rates of disease persistence.

Disclosure Nothing to disclose

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