Hiroshi  Kobayashi,Naoki Kawahara,Ryuji  Kawaguchi,Seiji  Mabuchi,Sho  Matsubara,Yoshinori  Takeda,Yuki  Yamada,
Prevention of Cervical Stenosis After Cervical Conization Using a Nelaton Catheter: A Retrospective Analysis of 556 Cases
Case Reports in Obstetrics Gynecology and Reproductive
2020
2674-5070
http://dx.doi.org/10.31487/j.CROGR.2020.01.03
https://www.sciencerepository.org/prevention-of-cervical-stenosis_CROGR-2020-1-103 
Abstract: Objective: This study aimed to investigate 1) the incidence of and risk factors for cervical stenosis, and 2)
the ability of prophylactic catheter insertion to prevent the cervical stenosis after cervical conization.
Methods: The clinical data of 556 females that were treated with cervical conization between August 2007
and December 2018 were collected. After excluding 65 postmenopausal women, the remaining 491 patients
were included in this study, and their data were retrospectively reviewed. Cervical stenosis was defined as
complete obstruction of the cervical canal or partial obstruction of the cervical canal accompanied by a
menstrual disorder that developed after cervical conization. The patients were divided into two groups
according to the catheter-indwelling period: the shorter group (catheter-indwelling period: <7 days) and
longer group (catheter-indwelling period: ≥7 days). Univariate and multivariate analyses were performed to
identify predictors of cervical stenosis.
Results: After a median follow-up period of 37.3 months, 80 (16.3%) patients had developed cervical
stenosis. Univariate and multivariate analyses confirmed that superficial conization (depth: <15mm) and a
long catheter-indwelling period after cervical conization were significantly associated with a reduced risk
of cervical stenosis.
Conclusion: Cervical stenosis occurred in 16.3% of patients who underwent cervical conization. It was
demonstrated that catheter insertion is safe and a longer catheter-indwelling period (≥7 days) and superficial
conization (depth: <15mm) are associated with a reduced risk of cervical stenosis after cervical conization.
Further prospective studies are needed to establish the optimal strategy for preventing cervical stenosis.Keywords: Cervical conization, cervical stenosis, menstrual disorders, prevention, Nelaton catheter