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Abstract: The patient in this case is a young woman who was diagnosed with high-risk HPV infection during a physical examination in 2017, but did not undergo any special treatment. 2020 physical examination at an outside hospital, TCT showed: low-grade squamous epithelial lesions, and colposcopy and cervical biopsy were performed to suggest grade II cervical precancerous lesions, so the patient was treated surgically to control the progression of the disease, and the patient recovered well after the operation, and no significant follow-up was seen. The patient recovered well after surgery and no significant abnormality was found at the follow-up examination, and is still under regular follow-up.
Basic information】Female, 31 years old
Disease Type】HPV infection
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】June 2021
Treatment plan】Surgical treatment (cervical loop electrodesiccation)
Treatment period】2 weeks post-operative recovery period, regular outpatient follow up
Effectiveness】The condition was controlled and the bleeding symptoms disappeared.
I. Initial consultation
The patient is a 31-year-old female, who was tested positive for HPV type 52 and negative for the rest in a physical examination in 2017, and negative for TCT (no relevant report card), and no special treatment was performed because she had no uncomfortable symptoms; in December 2020, she was examined in an outside hospital, and was not given any special treatment for atypical squamous epithelial cells (the significance of which could not be clarified) and positive for type 52; 20 days before the consultation, she was examined in our hospital, and a TCT examination was performed. TCT examination indicated low-grade squamous epithelial lesions, and HC2 examination indicated positive type 52. She complained of normal leukorrhea, no odor, no vaginal fluid and bleeding during intercourse, and normal urine and stool.
II. Treatment history
After the outpatient examination, I explained the patient’s condition and explained to her that the results of TCT and HC2 were abnormal, so colposcopy was needed to clarify the nature of the lesion, and if abnormalities were found during the colposcopy, a cervical biopsy would be performed under colposcopy, and then a treatment plan would be formulated based on the pathology report. The pathological examination results indicated a grade II precancerous cervical lesion, and after discussion with the patient, a cervical loop electrosurgery was performed to remove the diseased tissue.
III. Treatment effect
The patient underwent surgical treatment for cervical lesion excision, which stopped the further development of HPV infection. And the postoperative recovery was good. At the follow-up examination 1 month after surgery, the cervical wound healed well and no abnormality was seen. The TCT and HPV results were normal at the follow-up examination 3 months after surgery, 52 positive to negative, and no significant abnormality was seen at the subsequent follow-up examinations, and the patient is still under regular follow-up observation of her condition.
IV. Notes
The patient did not show any significant bleeding after surgery, and the surgery was more successful. The patient was obviously much more relaxed, and I was happy for the success of the patient’s surgery. The patient should be reminded to pay attention to postoperative care to avoid postoperative infection. First, avoid bathing and swimming until the cervical incision is completely healed at the follow-up examination; then, it is recommended that intercourse be prohibited for 3 months after surgery to avoid cervical bleeding caused by local irritation. In addition, physical labor, such as lifting heavy objects, is prohibited for 3 months.
V. Personal insight
For patients who are diagnosed with HPV infection as in this case and whose pathological examination confirms cervical precancerous lesions, timely surgical treatment is recommended to avoid the development of cervical cancer from persistent HPV infection. In addition, postoperative care is still needed to promote wound healing and physical recovery, and the discharge should be observed. If there is excessive vaginal blood and fluid discharge, even exceeding the menstrual volume, prompt medical attention should be sought.