The aim of this audit was to determine whether initial referral to a general gynecology clinic (GOPD) or a colposcopy
clinic is the most efficient means of managing women with postcoital (PCB) or intermenstrual (IMB) bleeding.
Materials and Methods.
A prospective audit of women with PCB or IMB was conducted. Sixty referrals from primary care were note-logged and alternatively allocated to either clinic. Data were collected by case note review.
Sixty women were referred for abnormal bleeding, 33 (55%) of which were seen at the GOPD and 27 (45%) at the colposcopy
clinic. Investigations included Chlamydia
testing, which was deficient in both settings, whereas ultrasound scans and hysteroscopies were performed in 9% of patients attending the GOPD compared with none in the colposcopy
clinic. The most common finding at the GOPD was cervical ectopy
in 14 (42%) patients. No abnormality was found in 9 (28%) patients. At colposcopy
, 14 (52%) had no abnormality detected, whereas 8 (30%) had cervical ectopy
and 3 (11%) had cervical intraepithelial neoplasia. There were no cases of malignancy found in this study.
Most patients with PCB and IMB will not have a serious abnormality. Our study proposes that a new PCB/IMB outpatient service can improve the efficiency of treatment of these women by providing appropriate guidelines to standardize their care.