Seguimiento y abordaje terapéutico de lesiones intraepiteliales de cuello uterino de mujeres en edad fértil, atendidas en el hospital IESS Ceibos en el 2019.

Abstract

Background: In 2013, cervical cancer was considered a public health problem worldwide, especially in women living under low socioeconomic conditions. According to the National Registry of Tumors of Solca, in Ecuador approximately 1600 new cases of uterine cuello each year. Objective: Evalue the screening and therapeutic approach of the intraepithelial lesions of uterine cells of women in fertile age attended at the IESS Ceibos Hospital during the year 2019. Methods: In order to evaluate the follow-up and therapeutic approach of cervical intraepithelial lesions of women of childbearing age treated at the IESS-Ceibos Hospital during 2019, the population treated in this period was analyzed, who presented intraepithelial alterations and were derived the Gynecology outpatient clinic for presenting a positive cervical cytology result for these alterations. Results: In the screening of pre-malignant lesions, the most used test was the control colposcopy every 6 months in 58% of the patients, followed by cytological control every 6 months in 38%, in 4% of the patients they had a diagnosis no follow-up recommendations. In the therapeutic approach, 86.74% of the patients underwent expectant treatment, different from the 6.12% of the patients who required resection of the cervical lesion with ASA LEEP, 5.10% of the cases required hysterectomy and 2.04% referred to a the patient to a more complex unit. Conclusion and Recommendation: We show that the most frequent intraepithelial lesions are low grade and that expectant treatment is followed, according to international protocols. We suggest that the co-test should be performed combining cytology and detection and molecular typing of HPV.