From the Departments of * Family Medicine, §Obstetrics and Gynecology, and ††Office of Biostatistics, Medical College of Georgia, Augusta, Georgia; †Department of Gynecologic Oncology and Urogynecology, KK Women and Children's Hospital, Singapore; ‡Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Canada; ∥Department of Gynecology, University of Sao Paulo, Sao Paulo, Brazil; ‡‡Department of Obstetrics and Gynecology, Bichat Claude Bernard Hospital, Paris, France; and the **Department of Obstetrics and Gynecology, Ninewells Hospital, University of Dundee, Dundee, Scotland.
J Low Genit Tract Dis. 2000 Apr;4(2):65-71.
To compare the colposcopic adequacy, colposcopic impressions, histologic sampling intent, biopsy site location, procedural complications, and difficulty of colposcopic examinations using optical and video colposcopes.
Women and men presenting consecutively for colposcopy were examined independently by two colposcopists using alternately either an optical or video colposcope. Colposcopists individually recorded their exam adequacy, colposcopic impression, biopsy intent and site, procedural complications, and difficulty of examination. Most colposcopists had no prior experience with video colposcopes.
Of 300 patients, mean age 35.3 years (±12.2 SD), examined, 29.7% were nulliparous, 4.9% pregnant, 52.5% had a previous biopsy and 34.3% had prior cervical treatment. Agreement between colposcopes was excellent for visualizing the complete squamocolumnar junction (75.6%, x = 6.40, p = 0.09). Colposcopists using the video colposcope had more unsatisfactory exams of the endocervical canal (36.6%, 97/265) than did colposcopists using optical colposcopes (24.9%, 66/265, x = 16.65, p = 0.001). Colposcopic impression agreement with pathology results were not significantly different between the video (58.1%) and optical (57.0%) colposcopes (x = 0.09, p = 0.8). Biopsy intent (79.9% agreement, x = 0.20, p = 0.7) and biopsy site selection by cervical quadrant were not significantly different for the two colposcopes. Both types of colposcopes were rated extremely easy to use, but colposcopy in general (T = 3.97, p < 0.001), visualization (T = 2.98, p = 0.002), assessment (T = 2.76, p = 0.004), and sampling (Wilcoxon = 2.27, p = 0.02) were determined to be easier when using optical colposcopes.
Video colposcopes have similar, clinically relevant outcomes when compared with optical colposcopes. Colposcopists using optical colposcopes reported easier colposcopy exams and fewer unsatisfactory examinations of the endocervical canal. These findings may represent a learning curve effect as colposcopists become familiar with operating the video colposcope.▪.
比较光学和视频阴道镜检查在阴道镜检查的充分性、阴道镜印象、组织学取样意图、活检部位定位、操作并发症和阴道镜检查的难度。
连续进行阴道镜检查的女性和男性由两名阴道镜医师独立使用光学或视频阴道镜交替检查。阴道镜医师分别记录他们的检查充分性、阴道镜印象、活检意图和部位、操作并发症以及检查的难度。大多数阴道镜医师以前没有使用过视频阴道镜。
在 300 名接受检查的患者中，平均年龄为 35.3 岁（±12.2 标准差），29.7%为未婚，4.9%为孕妇，52.5%有先前的活检，34.3%有先前的宫颈治疗。对于完整的鳞柱状交界的可视化，两种阴道镜之间的一致性非常好（75.6%，x=6.40，p=0.09）。使用视频阴道镜的阴道镜医师对宫颈内口的检查不满意的比例（36.6%，97/265）高于使用光学阴道镜的医师（24.9%，66/265，x=16.65，p=0.001）。阴道镜印象与病理结果的一致性在视频（58.1%）和光学（57.0%）阴道镜之间没有显著差异（x=0.09，p=0.8）。两种阴道镜的活检意图（79.9%的一致性，x=0.20，p=0.7）和宫颈象限选择的活检部位没有显著差异。两种阴道镜均被评为使用非常容易，但阴道镜检查（T=3.97，p<0.001）、可视化（T=2.98，p=0.002）、评估（T=2.76，p=0.004）和取样（Wilcoxon=2.27，p=0.02）使用光学阴道镜时更容易。
与光学阴道镜相比，视频阴道镜具有相似的、具有临床相关性的结果。使用光学阴道镜的阴道镜医师报告说阴道镜检查更容易，宫颈内口检查不满意的比例更低。这些发现可能代表了操作视频阴道镜时的学习曲线效应，因为阴道镜医师对其操作越来越熟悉。
