Prevention of Cervical Stenosis After Cervical Conization Using a Nelaton Catheter: A Retrospective Analysis of 556 Cases

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.