Auditing the Use of Colposcopy Versus General Gynecology Clinics to Investigate Women With Postcoital or Intermenstrual Bleeding: A Case for a New Outpatient Service

Vanessa Harry (Corresponding Author), Margaret Eleanor Cruickshank, David Parkin

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective. The aim of this audit was to determine whether initial referral to a general gynecology clinic (GOPD) or a colposcopy clinic is the most efficient means of managing women with postcoital (PCB) or intermenstrual (IMB) bleeding.

Materials and Methods. A prospective audit of women with PCB or IMB was conducted. Sixty referrals from primary care were note-logged and alternatively allocated to either clinic. Data were collected by case note review.

Results. Sixty women were referred for abnormal bleeding, 33 (55%) of which were seen at the GOPD and 27 (45%) at the colposcopy clinic. Investigations included Chlamydia testing, which was deficient in both settings, whereas ultrasound scans and hysteroscopies were performed in 9% of patients attending the GOPD compared with none in the colposcopy clinic. The most common finding at the GOPD was cervical ectopy in 14 (42%) patients. No abnormality was found in 9 (28%) patients. At colposcopy, 14 (52%) had no abnormality detected, whereas 8 (30%) had cervical ectopy and 3 (11%) had cervical intraepithelial neoplasia. There were no cases of malignancy found in this study.

Conclusion. Most patients with PCB and IMB will not have a serious abnormality. Our study proposes that a new PCB/IMB outpatient service can improve the efficiency of treatment of these women by providing appropriate guidelines to standardize their care.
Original languageEnglish
Pages (from-to)108-111
Number of pages4
JournalJournal of Lower Genital Tract Disease
Volume11
Issue number2
DOIs
Publication statusPublished - Apr 2007

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Colposcopy
Metrorrhagia
Polychlorinated Biphenyls
Ambulatory Care
Gynecology
Referral and Consultation
Hysteroscopy
Cervical Intraepithelial Neoplasia
Chlamydia
Primary Health Care
Guidelines
Hemorrhage
Neoplasms
Therapeutics

Keywords

  • postcoital bleeding
  • intermenstrual bleeding
  • colposcopy
  • cervical cytology
  • ectopy

Cite this

@article{f67ec4f711d040fe9122669e3ab76148,
title = "Auditing the Use of Colposcopy Versus General Gynecology Clinics to Investigate Women With Postcoital or Intermenstrual Bleeding: A Case for a New Outpatient Service",
abstract = "Objective. The aim of this audit was to determine whether initial referral to a general gynecology clinic (GOPD) or a colposcopy clinic is the most efficient means of managing women with postcoital (PCB) or intermenstrual (IMB) bleeding. Materials and Methods. A prospective audit of women with PCB or IMB was conducted. Sixty referrals from primary care were note-logged and alternatively allocated to either clinic. Data were collected by case note review. Results. Sixty women were referred for abnormal bleeding, 33 (55{\%}) of which were seen at the GOPD and 27 (45{\%}) at the colposcopy clinic. Investigations included Chlamydia testing, which was deficient in both settings, whereas ultrasound scans and hysteroscopies were performed in 9{\%} of patients attending the GOPD compared with none in the colposcopy clinic. The most common finding at the GOPD was cervical ectopy in 14 (42{\%}) patients. No abnormality was found in 9 (28{\%}) patients. At colposcopy, 14 (52{\%}) had no abnormality detected, whereas 8 (30{\%}) had cervical ectopy and 3 (11{\%}) had cervical intraepithelial neoplasia. There were no cases of malignancy found in this study. Conclusion. Most patients with PCB and IMB will not have a serious abnormality. Our study proposes that a new PCB/IMB outpatient service can improve the efficiency of treatment of these women by providing appropriate guidelines to standardize their care.",
keywords = "postcoital bleeding, intermenstrual bleeding, colposcopy, cervical cytology, ectopy",
author = "Vanessa Harry and Cruickshank, {Margaret Eleanor} and David Parkin",
year = "2007",
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language = "English",
volume = "11",
pages = "108--111",
journal = "Journal of Lower Genital Tract Disease",
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publisher = "Lippincott Williams and Wilkins",
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T2 - A Case for a New Outpatient Service

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AU - Cruickshank, Margaret Eleanor

AU - Parkin, David

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N2 - Objective. The aim of this audit was to determine whether initial referral to a general gynecology clinic (GOPD) or a colposcopy clinic is the most efficient means of managing women with postcoital (PCB) or intermenstrual (IMB) bleeding. Materials and Methods. A prospective audit of women with PCB or IMB was conducted. Sixty referrals from primary care were note-logged and alternatively allocated to either clinic. Data were collected by case note review. Results. Sixty women were referred for abnormal bleeding, 33 (55%) of which were seen at the GOPD and 27 (45%) at the colposcopy clinic. Investigations included Chlamydia testing, which was deficient in both settings, whereas ultrasound scans and hysteroscopies were performed in 9% of patients attending the GOPD compared with none in the colposcopy clinic. The most common finding at the GOPD was cervical ectopy in 14 (42%) patients. No abnormality was found in 9 (28%) patients. At colposcopy, 14 (52%) had no abnormality detected, whereas 8 (30%) had cervical ectopy and 3 (11%) had cervical intraepithelial neoplasia. There were no cases of malignancy found in this study. Conclusion. Most patients with PCB and IMB will not have a serious abnormality. Our study proposes that a new PCB/IMB outpatient service can improve the efficiency of treatment of these women by providing appropriate guidelines to standardize their care.

AB - Objective. The aim of this audit was to determine whether initial referral to a general gynecology clinic (GOPD) or a colposcopy clinic is the most efficient means of managing women with postcoital (PCB) or intermenstrual (IMB) bleeding. Materials and Methods. A prospective audit of women with PCB or IMB was conducted. Sixty referrals from primary care were note-logged and alternatively allocated to either clinic. Data were collected by case note review. Results. Sixty women were referred for abnormal bleeding, 33 (55%) of which were seen at the GOPD and 27 (45%) at the colposcopy clinic. Investigations included Chlamydia testing, which was deficient in both settings, whereas ultrasound scans and hysteroscopies were performed in 9% of patients attending the GOPD compared with none in the colposcopy clinic. The most common finding at the GOPD was cervical ectopy in 14 (42%) patients. No abnormality was found in 9 (28%) patients. At colposcopy, 14 (52%) had no abnormality detected, whereas 8 (30%) had cervical ectopy and 3 (11%) had cervical intraepithelial neoplasia. There were no cases of malignancy found in this study. Conclusion. Most patients with PCB and IMB will not have a serious abnormality. Our study proposes that a new PCB/IMB outpatient service can improve the efficiency of treatment of these women by providing appropriate guidelines to standardize their care.

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