Do women referred for colposcopy receive adequate information from the primary care team?

The objective of this study was to assess whether women had been counselled by their primary health care team and whether or not they had received any information about colposcopy. We also asked where the best information had been obtained. The setting was the colposcopy clinic of a large district general hospital, the design of which was a cross-sectional audit using a questionnaire. The subjects were 100 women attending the colposcopy clinic. The results show that 63% of women were seen by their primary health care team before the colposcopy visit and that counselling was associated with knowledge about colposcopy (P = 0.017). However, 43% of women felt that they knew nothing about colposcopy whilst 19% of women thought that the information they had obtained was not useful. We conclude that there is scope for improving the quality, timing and provision of information for women undergoing colposcopy.

A comparison of the side effects of prilocaine with felypressin and lignocaine with adrenaline in large loop excision of the transformation zone of the cervix: results of a randomised trial

OBJECTIVE

To test the hypothesis that prilocaine with felypressin causes fewer side effects than lignocaine with adrenaline when performing large loop excision of the transformation zone of the cervix.

DESIGN

Randomised trial.

SETTING

Colposcopy clinic in a large district general hospital.

PARTICIPANTS

Two hundred consecutive women undergoing large loop excision of the transformation zone of the cervix.

METHODS

Two different local anaesthetic combinations (prilocaine with felypressin and lignocaine with adrenaline) were compared in women undergoing large loop excision of the transformation zone. Prospective collection of clinical and treatment data was undertaken with scoring using an ordinal scale of pain experienced by the women during the procedure. Peri-operative blood loss and any side effects were also recorded.

MAIN OUTCOME MEASURES

Side effects associated with the local anaesthetic agents.

RESULTS

Lignocaine with adrenaline resulted in less blood loss (P = 0.006) but was more likely to cause side effects, such as feeling faint (P = 0.017) and shaking (P < 0.001).

CONCLUSION

Prilocaine with felypressin causes fewer side effects than lignocaine with adrenaline and is therefore the preferred local anaesthetic combination for large loop excision of the transformation zone.

Is the provision of information leaflets before colposcopy beneficial? A prospective randomised study

OBJECTIVE

To assess the usefulness of a leaflet distributed to women before colposcopy designed to reduce their anxiety and psychosexual morbidity by providing information.

DESIGN

Prospective randomised study.

SETTING

Colposcopy clinic of a large district general hospital.

SAMPLE

Two hundred consecutive women undergoing colposcopy for the first time for a cervical cytological abnormality of severity no greater than moderate dyskaryosis.

METHODS

Women were randomised into one of two groups (leaflet or control). Those in the leaflet group were sent an information leaflet prior to attending the clinic. In the colposcopy clinic all the women completed a State/Trait Anxiety Inventory (StAI/TrAI) and a modified psychosexual questionnaire before undergoing colposcopy. This was repeated at the six-month follow up visit. Women in the leaflet group also completed a further questionnaire on the leaflet.

MAIN OUTCOME MEASURES

Differences of anxiety and psychosexual scores between leaflet and control groups.

RESULTS

The leaflet was well received. There were no statistical differences in StAI and TrAI scores between the study group and the control group at either visit, although in the whole study population StAI and TrAI scores were reduced at the second visit. The leaflet group had significantly more psychosexual problems but by the second visit, the scores had improved and the two groups were similar. When the mean differences in anxiety and psychosexual scores at the initial and second visits were compared between the groups, the reduction in negative sexual feelings and deterioration of TrAI scores experienced by the leaflet group was significant.

CONCLUSIONS

This study suggests that the provision of sending an information leaflet prior to colposcopy is not beneficial in isolation. Other approaches need to be considered.