Cervical Cytological and Colposcopic Findings in Cases Associated with Prolonged Use of Intrauterine Devices versus Long Acting Injectable Contraceptive Agents

Background: Early detection and treatment of cervical neoplasia depends on the accurate interpretation of the cytologic sample. This study aimed to assess cervical cytological and colposcopic findings in cases associated with prolonged use of Copper T 380 intrauterine devices (IUD) versus long acting depot medroxy-progesterone acetate injectable contraceptive agents.Methods: This case control study was conducted on 120 women who were using Copper T 380A intrauterine contraceptive device or long acting depot medroxy-progesterone acetate injections at least 3 years, asymptomatic seeking regular cervical screening program, or symptomatic with contact bleeding. Patients were divided into two equal groups: Group A: women using Copper T 380A intrauterine contraceptive device (Pregna®, DKT, Egypt), and Group B: women using depot medroxy-progesterone acetate contraceptive injections (Oxyprogest®, 150mg, vial, Acdima, Egypt). ALL patients were subjected to colposcopy and pap smear.Results: Colposcope was an accurate method for assessment of women with suspected cervical lesion using long term contraceptive method either IUD or hormonal injections with sensitivity 98%, specificity 92.9%, PPV 90.7% and NPV 98.5% respectively. Long term IUD users were proved to have higher frequency of bleeding 40 (66.7%) vs. 29 (48.3%), discharge 46 (76.7%) vs. 31 (51.7%), pain 28 (46.7%) vs. 16 (26.7%) and abnormal colposcopic findings 33 (55.0%) vs. 21 (35.0%) and cervical biopsies 31 (51.7%) vs. 19 (31.7%) compared with long term hormonal injections users.Conclusion: Colposcope was an accurate method for assessment of women with suspected cervical lesion using long term contraceptive method either IUD or hormonal injections.