Cervical cytology after cryosurgery, laser ablation and conization. A comparison of the cotton swab and endocervical brush.

Obtaining an adequate Papanicolaou smear, as evidenced by the presence of endocervical cells, is paramount in following patients after treatment for cervical dysplasia. A randomized, prospective trial was done in which 203 patients with a history of cryosurgery, laser ablation or cone biopsy were randomized into two groups: 114 patients had cervical smears done with a cotton swab and 89 patients with an endocervical brush. The presence or absence of endocervical cells was noted on the cytology report. Overall, the endocervical brush produced significantly more adequate smears than did the cotton swab (86% vs. 74%, P = .0389). Within each subgroup the endocervical brush consistently produced a higher number of adequate smears than did the cotton swab: after cryosurgery, 86% vs. 82%, P = .7242; after laser ablation, 95% vs. 88%, P = .61; after conization, 76% vs. 47%, P = .0675. The difference was most notable in the conization group. The endocervical brush is superior to the cotton swab in obtaining satisfactory Papanicolaou smears after cryosurgery, laser ablation and conization.