Abstract
Introduction In connection with the reorganisation of cervical carcinoma screening, the importance
of colposcopy as an integral part of the planned series of clarification testing will
greatly increase. Quality standards for performing the colposcopic examination should
therefore be defined in detail. A precondition for this is surveying the current standard
in clinical practice. The objective of this study was to evaluate the current practice
of colposcopy and conisation in Germany by means of a questionnaire aimed at gynaecologists
who perform colposcopies in order to document the actual therapeutic standard of treatment
of cervical dysplasia.
Materials and Methods Gynaecologists were invited via e-mail or during events to participate in a web-based
survey. The questionnaire contained 38 questions on management before, during and
after the examination as well as questions on the technical implementation of colposcopy
and conisation.
Results From February 2018 to April 2018, 961 e-mails were sent. A response was received
in 197 cases (response rate 20.5%). Responses were received for another 40 questionnaires
during events (response rate approx. 80%). After taking the inclusion criteria into
account, 160 questionnaires were evaluated. The majority of those surveyed take an
average of 2 cervical biopsies (67.3%) and nearly all of those surveyed (94.5%) do
not use any local anaesthetic. As a standard method for removing cervical precancerous
cells, most of the physicians surveyed perform a loop excision with the electrosurgical
loop (91.2%) under colposcopic visualisation (61.2%) under general anaesthesia (92.5%).
Postoperative bleeding prophylaxis by means of tamponade is performed only in 27.6%
of all cases.
Conclusion A differential colposcopy with two colposcopically targeted biopsies and treatment
with the electrosurgical loop are the methods most frequently used by clinicians who
perform colposcopy in Germany. A uniform procedure should be defined in detail within
the scope of directives or guidelines.
Key words
CIN - colposcopy - conisation - management - screening - cervical dysplasia - cervical
carcinoma
