Clinical Study of Tranexamic Acid in Treatment of Cervical Ectopy-AnInstitutional Experience

Abstract

Background: Cervical ectopy is a common entity among women attending gynaecological OPD for various complaints which itself could be the cause or present otherwise. The treatment modalities currently available are electrocoagulation, cry cauterization, laser cauterization, and drug treatment. Most of these procedures require a high learning curve, associated with side-effects, and are costly. Furthermore, routine treatment for ectopy has long been debated and there are no current guidelines for the same. Tranexamic acid, with its easy applicability, availability, and minimal costs could be an effective alternative. Objective: To evaluate the therapeutic effectiveness and safety of topical tranexamic acid for the treatment of cervix erosion. Methodology: A total of 75 cases of cervical erosion were taken who satisfied the inclusion and exclusion criteria of the study. Patients were randomized into two groups. Local application of tranexamic acid (Group A, n=38) or povidone-iodine solution (Group B, n=37) for 5 minutes were applied with the patient position kept constant for 15 minutes and daily dosage were given for 10 days. All the patients were followed up at the end of 2nd and 4th week and after 3 months for complete healing, relief of symptoms like chronic pelvic pain, recurrent vaginitis, contact bleeding, and vaginal discharge, and possible side effects. Results: In group A, all 7 and 20 patients complaining of chronic pelvic pain and contact bleeding respectively were cured of it (100% cure). For the other symptoms such as recurrent vaginitis and vaginal discharge, cure rates were 81.25% and 87.5% respectively. In group B, the cure was seen only in vaginal discharge with 12 patients getting cured out of 33 (36.36%) and no response in other symptoms. Side effect in the form of vaginal irritation was found only in group B in 17 patients (45.94%) whereas none were observed in group A who received the tranexamic acid application. We observed a positive correlation between cervical erosion and tranexamic acid application in terms of healing and side effects. Conclusion: Tranexamic acid application is a promising new treatment modality of cervical erosion in symptomatic women.