Introduction/Background The persistence of the Human Papilloma Virus (HPV) after conization is considered a risk factor for recurrence and/or progression of the lesion.
Methodology A retrospective descriptive study is carried out on the 73 conizations that we have carried out during the year 2020 at the Juan Ramón Jiménez Hospital. The variables analyzed were the pathological anatomy, the HPV test prior to conization, the intra-surgical HPV test and the one performed together with the cytology four months after conization. The statistical parameter used was chi square.
Results Analyzing the intraoperative HPV test, of the 73 patients who underwent conization, 33 were positive test, which represents 45.2% of the total number of patients operated on. The HPV test remained positive in 22 of the 73 patients in the first review (corresponding to 30.14% of all patients). Of these, 50% (11 women) presented cytological alterations in the first review after conization. Six patients required a second conization. One of our patients required a hysterectomy due to the persistence of moderate-severe dysplasia in endocervical curettage, very effaced cervix (difficult to assess) and cervical stenosis, which made the patient a case of difficult follow-up. Analyzing the cytological results prior to the first conization in the patients who were reconized, of these 6 patients, 5 presented H-SIL and 1 patient presented ASCUS.
Conclusion In patients in whom HPV persists in the first post-conization check-up, the rate of reconization and hysterectomy due to progression of dysplastic lesions is higher than in those in whom the HPV test was negative (statistically significant difference, p 0.001). . We also found a different percentage of reconization depending on the cytological result. On the other hand, although the cytological diagnosis prior to the firsseems to influence, in our case, the subsequent reconization rate we have not found statistically significant differences.
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