Abstract
Objective: To evaluate acupuncture as a therapeutic method for uterine cervical ectopy with analysis of risk factors that interfere with the metaplastic response. Materials and Methods: From November 2010 to December 2015, the authors selected 51 healthy women with ectopy, reproductive age, no previous therapy, and negative conventional cytology Pap smear (CPS) for malignancy in the study group (S), treated with ten acupuncture sessions, weekly, and control group (C) with expectant management. The authors conducted anamnesis directed to Traditional Chinese Medicine (TCM), collection for liquid-based cytology (LBC), and colposcopy with photographs at study inclusion and follow-up at 90 days. The authors evaluated the therapeutic response by means of computerized planimetry in the images with 3% acetic acid solution (aa), considering the differential of the percentages of the areas of ectopy (ΔPe). The data were analyzed statistically. Results: Group S had 23 women and group C had 28. The mean age was 25.6 years, predominantly Caucasian, symptomatic, and non-smokers (100%). Group S presented a later age for first sexual intercourse (p < 0.001) and used less hormonal contraceptives (p < 0.001). LBC confirmed benignity and found no deviation of flora for bacterial vaginosis (BV). Group S presented higher ΔPe than C (p < 0.001). Conclusions: The authors observed a favorable therapeutic effect of acupuncture on the metaplastic process. The use of hormonal contraceptives and age of first sexual intercourse were the relevants risk factors, the same did not occur in smoking subjects and in the deviation of flora to BV.
Highlights
The uterine cervix is covered by squamous epithelium in the ectocervix and by columnar epithelium in the endocervix
Ectopy is the presence of columnar epithelium on the ectocervix [1]
Re-epithelialization of the ectocervix occurs spontaneously, through metaplasia of the columnar epithelium triggered by the Ph vaginal acid
Summary
The uterine cervix is covered by squamous epithelium in the ectocervix and by columnar epithelium in the endocervix. Ectopy is the presence of columnar epithelium on the ectocervix [1]. It is considered a physiological phenomenon originating in embryogenesis [2]. The squamous columnar junction may vary during female life by the influence of the sexual steroids [3]. It affects young women, reaching a prevalence of 17% to 50% of the cases [2]. Re-epithelialization of the ectocervix occurs spontaneously, through metaplasia of the columnar epithelium triggered by the Ph vaginal acid. Influenced by hormonal stimulation, the process may extend for months or years [1]. For this reason, the treatment is currently controversial [2]. The risk factors involved in the persistence of ectopy are those that interfere with metaplasia such as BV, combined oral contraceptive (COC) use, and smoking [1, 5]
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