Comparison of an intraoral camera with colposcopy in sexually abused children.
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This study examined the prevalence of human papillomavirus (HPV) infection in a cohort of female sex workers in Singapore. HPV infection was diagnosed by clinical examination, Papanicolaou (Pap) smears, histology and polymerase chain reaction (PCR). One hundred and eighty-seven female sex workers who came for their routine medical screening were enrolled into the study. PCR was positive for HPV in 27 (14.4%), 20 of these had a single HPV type detected, while 7 had multiple types of HPV detected. The most common HPV types identified were types 16, 58 and 18. In conclusion, HPV infection is moderately prevalent among sex workers as tested by PCR, but routine screening with Pap smears does not appear to be a sensitive method of diagnosis for HPV infection.
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Investigation has been performed upon 29 patients of average age of 62.7 years who have undergone sacrospinous colpopexy because of different degree of uterovaginal prolapse (26 patients) and vaginal vault prolapse (3 patients) after having abdominal or vaginal hysterectomy. In patients with uterovaginal prolapse, 23 of them have vaginal hysterectomy with high ligation of the enterocele sac, anterior et posterior vaginal repair and sacrospinous colpopexy, while 3 patients had conservation of uterus following previous reparation of vaginal walls and cervicosacrocolpopexy. Only in one patient we had intraoperative lession of the bladder with no other intraoperative complications so far. Aveage time duration of the operation was 112 minutes. All patients were scheduled to be seen at 4 weeks, 6 months and 12 months after operation and then yearly therafter. The mean follow-up period was 16.8 months (6-27). We have achieved satisfactory results in 25 patients while 4 patients have bladder instability, 3 patients suffered from urinary infection, 2 have febrile morbidity and 2 bottock pain. Sacrospinous colpopexy can be performed together with vaginal hysterectomy and anterior and posterior vaginal wall repair in patients with marked uterovaginal prolapse because of its high success in avoiding possible vault prolapse and low intra and post-operative complication rates.
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Various methods presently available for the diagnosis of genital Human Papilloma Virus (HPV) were compared regarding their sensitivity in women referred for specific diagnosis and treatment because of atypical Pap smears or clinically suspected neoplasia. Colposcopic examination was performed in all cases. In addition to taking a second Pap smear, cell suspensions were made from 105 women and analysed by the Filter In Situ Hybridization (FISH) technique and tested for HPV 6 + 11 and HPV 16 + 18 + 31. The FISH technique was also used for the possible detection of HPV-DNA in a reference material comprising 119 apparently healthy women with normal Pap smears. Colposcopically directed cervical biopsies in altogether 196 specimens were obtained from 155 women for histopathological examination and also for the detection of HPV-DNA by the Southern blot hybridization technique. These specimens were tested for the presence of HPV 6, 11, 16, 18, 31 and 33. Three per cent of the women with and 34% without cytological signs of HPV in Pap smears had cervical intraepithelial neoplasia (CIN) III according to histopatology. CIN III was present in 35% of biopsies with and 59% of biopsies without histological signs of HPV in the biopsies. Altogether 46% of the women were HPV-DNA positive. Of the women analysed by Southern blot, 39% were HPV-DNA positive. Of the samples analysed by FISH, 27% with atypical cells were HPV-DNA positive, compared with 11% of the samples from reference women with normal cytology.(ABSTRACT TRUNCATED AT 250 WORDS)
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