Selection of surgical methods for cervical high-grade squamous intraepithelial lesions after menopause

Objective To explore the surgical methods for patients with cervical high-grade squamous intraepithelial lesions (HSIL) after menopause.

Methods Clinical materials of 293 patients with cervical cold-knife coning and hysterectomy for cervical HSIL were retrospectively analyzed. The pathological accuracy of colposcopic biopsy and coning resection in postmenopausal patients was compared, and the incidence rates of biopsy and extrascial total hysterectomy or extensive hysterectomy in postmenopausal patients with cervical HSIL were compared.

Results The pathological coincidence rate of postmenopausal women after coning was higher than biopsy. For cervical intraepithelial neoplasias (CIN) Ⅱ patients, there was no significant difference in the outcome of surgical selection based on biopsy and conical incision results (P>0.05). For CIN Ⅲ patients, treatment based on biopsy and conical incision results showed a significant difference in outcomes (P < 0.05).

Conclusion In postmenopausal women, the coincidence rate between post-biopsy pathology and final pathology is significantly lower than that between pathology and final pathology after conical resection. For postmenopausal women with CIN Ⅱ biopsy pathology and difficulty in conical resection surgery, total extrascial hysterectomy is recommended; for CIN Ⅲ patients, cold knife conical resection of cervix is recommended first, and further diagnosis and treatment plan is determined according to the conical pathology.