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Japanese Journal of Clinical Oncology Advance Access published online on October 29, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp140
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© The Author (2009). Published by Oxford University Press. All rights reserved

Can Vaginal Misoprostol Effectively Increase Rate of a Satisfactory Colposcopy? A Randomized Double-blind Placebo-controlled Trial*

Duangmani Thanapprapasr1, Sarikapan Wilailak1, Nathpong Israngura Na Ayudhya1, Arb-aroon Lertkhachonsuk1, Puchong Likittanasombut1, Suwicha Chittithaworn1, Chuenkamon Charakorn1 and Sawaek Weerakiet2

1 Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
2 Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

For reprints and all correspondence: Duangmani Thanapprapasr, Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. E-mail: radtn{at}mahidol.ac.th

Received April 23, 2009; accepted September 19, 2009

Objective: To evaluate the effectiveness of vaginal misoprostol in overcoming an unsatisfactory colposcopy in the patients who had abnormal cervical cytology and to evaluate side effects of vaginal misoprostol.

Methods: Sixty patients with an unsatisfactory colposcopy during the period of September 2007–November 2008 were recruited and randomly allocated to receive either two tablets of 200 µg misoprostol (400 µg) or two tablets of similar-looking placebo vaginally. Colposcopic re-examination was performed ~6 h later. The results and side effects before and 2 weeks after the colposcopic re-examination were recorded.

Results: Six out of 30 patients in the misoprostol group (20.0%) had a satisfactory colposcopic re-examination compared with 2 out of 27 patients (7.4%) in the placebo group without statistically significant difference (P = 0.172). Three patients in the placebo group dropped out due to not present at the appointment time. Six out of 30 patients (20.0%) and 1 out of 30 patients (3.3%) in the misoprostol group had side effects before and 2 weeks after the colposcopic re-examination orderly. Twenty-seven patients in the placebo group did not have any side effects before and 2 weeks after the colposcopic re-examination. All side effects occurred were minimal and well tolerated.

Conclusions: Four hundred micrograms of vaginal misoprostol were not proved to be effective in converting an unsatisfactory to a satisfactory colposcopy.

Key Words: misoprostol • unsatisfactory colposcopy

* This article was presented as poster presentation at International Gynecologic Cancer Society 12th Biennial Meeting 2008, Bangkok, Thailand.


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