Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal Colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and misoprostol for the enhancement of TZ visibility in vaginal Colposcopy of premenopausal and postmenopausal women. Materials & Methods: In this clinical trial, 78 patients with unsatisfactory Colposcopy were randomly divided into three groups. Group 1 (n=25) received 25 µ, g of vaginal estradiol for 14 days prior to Colposcopy. Group 2 (n=27) received 400 µ, g of misoprostol 12 h prior to Colposcopy. Group 3 (n=26) served as the control group and did not receive any medication. Visibility of the TZ, age, body mass index (BMI), history of vaginal delivery, history of sexually transmitted diseases, history of human papillomavirus (HPV), the reason for Colposcopy, and drug-related side effects were compared among the three groups and also between premenopausal and postmenopausal women. Data were analyzed using analysis of variance (ANOVA), Kruskal-Wallis, Chi-square, and Fisher’, s exact tests. Results: The percentage of TZ visibility was 72%, 55. 6%, and 26. 9% in the estradiol, misoprostol, and control groups, respectively (P=0. 005). These values were 70%, 33. 3%, and 0%, respectively, in postmenopausal women (P=0. 043) and 60%, 72. 7%, and 33. 3%, respectively, in premenopausal women (P=0. 152). Regarding drug-related side effects, there was no statistically significant difference between the three groups (P=0. 374). Conclusion: Estradiol was significantly superior to misoprostol for the enhancement of TZ visibility, particularly in postmenopausal women, with no difference regarding side effects.

Background: Cervical cancer is a common malignancy in women and HPV infection is directly linked to it and can be considerably prevented through routine screenings. Despite the belief about the persistence of HPV infection in older than 30-year-old women, high-grade lesions might be detected in younger ages,therefore, the purpose of the current study is to determine the worth of HPV infection screening in younger than 30-year-old women. Materials and Methods: This cross-sectional study has been executed on 100 under 30-year-old women who have undergone genotyping. Fourteen HPV subtypes including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 were defined as high risk and the patients were categorized in HPV 16/18 or other high-risk groups. Pap smear and Colposcopy were performed for both groups and interpreted as normal, low-risk and high-risk lesions and compared between the groups. Results: In terms of demographic, clinical, and sexual behavioral characteristics, the present study exhibited similarity (P value > 0. 05). Pap smear (P value = 0. 100) and Colposcopy (P value = 0. 711) grading did not differ between those with HPV 16/18 versus other high-risk HPV patients. Pap smear and colposcopic findings were weekly in agreement (κ < 0. 5, P value < 0. 001). Conclusion: Early cytological plus genotyping assessment in women at early child-bearing ages seems logical, as the cervical premalignant lesions have a slow progressing nature and can be easily treated in early stages.

Background and Objectives: Although several studies have been achieved on the frequency of the HPV types among women with cervical cancer in Iran, HPV-positive samples were in some cases directed to specific-primer genotyping of HPV 16 and 18. Therefore, the other HPV types are underestimated. Several studies have also reported a greater prevalence of HPV 16 in cervical cancer in Iran than in the world. To clarify these subjects, the distribution of HPV types in women referred for Colposcopy in Tehran was investigated. Materials and Methods: In this cross-sectional study, a total of 148 cervical samples from women with normal, atypical squamous cells of undetermined significance, cervical intraepithelial neoplasia I-III, and invasive cervical cancer histopathology were included. HPV was detected by PCR assay and all HPV-positive specimens were subjected to direct nucleotide sequencing. Results: Our results demonstrated that the total prevalence of HPV was 92.5%. The five most common HPV types were HPV 16 (49.3%), 18 (14.8%), 6 (7.4%), 31 (4.1%), and 11 (2.7%). About the histopathological stage, HPV 16 and 18 were dominant in all studied groups. In cervical cancer, HPV 16 and 18 were detected in 60% and 20% of cases, respectively. Conclusion: HPV 16 and 18 were the most common in cervical cancer in Iran.

Objectives: Cervical cancer is a very common and lethal condition; however, owing to longstanding premalignant lesions, it is possible to prevent morbidity and mortality by screening tests. Pap smear, Colposcopy, and biopsy are among the main modalities in this regard, however there is no consensus on the diagnostic utility of the first 2 methods. This study sought to examine the diagnostic utility of Pap smear, Colposcopy, and cytology in evaluating the non-benign cervical lesions. Materials and Methods: A cross-sectional study was carried out between 2014 and 2016 in an out-patient setting at Alzahra teaching hospital of Tabriz University of Medical Sciences. After obtaining informed consent, all 315 participants with abnormal Pap test underwent Colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as a gold standard and the diagnostic values of Pap smear and Colposcopy were individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. Results: The mean age of patients was 38. 49± 10. 31 years (17-68 years). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9. 8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of Pap smear in revealing non-benign cervical lesions were 77. 4%, 69. 7%, 21. 8%, 95. 6%, 70. 7%, and 2. 55%, and for Colposcopy, were 90. 3%, 90. 9%, 51. 9%, 98. 9%, 90. 8%, and 99. 2%, respectively. Conclusions: Based on our results, the Colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited. Therefore, this method should not be considered as the main criterion for decision making.