How Alarming Is Post-Coital Bleeding – A Cytologic, Colposcopic and Histopathologic Evaluation

This retrospective analysis studies post-coital bleeding (PCB) in 110 patients presenting to the colposcopy clinic of the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, and covers a 2-year period from March 1994 to February 1996. All the patients were evaluated by cytology and colposcopy. Colposcopy-positive patients underwent a directed biopsy. Age, parity and duration of PCB were correlated with histopathologic findings, i.e. benign changes, viral HPV changes and cervical intra-epithelial neoplasia (CIN) 1, CIN 2 and 3 and invasive cancer for risk assessment. 85.5% of the patients had benign findings, 5.6% viral HPV and CIN 1, 3.6% CIN 2 and 3 and 5.5% invasive cancer. Vascular ectopy was the commonest benign colposcopic finding. Cytology had a sensitivity and specificity of 56% and 90%, respectively. The mean age of patients with invasive cancer was 41.3 years versus 32.9 years in patients with benign pathology, the difference being statistically significant (p < 0.05). Mean parity was 4.2 in patients with invasive cancer against 2.8 in benign cases (NS). There was no correlation between duration of bleeding and pathology.