{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:47:51Z","timestamp":1763642871864},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To determine whether regular cervical dilatation is effective for preventing cervical stenosis, and to identify the associated risk factors, in postmenopausal women after LEEP. This was a prospective randomized clinical trial in postmenopausal women who underwent LEEP at our hospital between August 2018 and May 2019. Patients who met the study criteria were randomly allocated to three groups: control group (without any intervention), intervention group A (underwent cervical dilatation at the 3<jats:sup>rd<\/jats:sup>, 5<jats:sup>th<\/jats:sup>, and 8<jats:sup>th<\/jats:sup> week after LEEP) and intervention group B (underwent cervical dilatation at the 4<jats:sup>th<\/jats:sup>, 8<jats:sup>th<\/jats:sup>, and 12<jats:sup>th<\/jats:sup> week after LEEP). A colposcopic follow-up examination was conducted at 6 months after LEEP to determine the incidence of cervical stenosis. A total of 404 postmenopausal women were found to be finally eligible for the study. The rate of cervical stenosis in the control group was significantly higher than that in the intervention group, and the rate in group A was significantly lower than that in group B. We found regular dilatation after LEEP in postmenopausal women can prevent cervical stenosis. Further, the 3rd, 5th, and 8th weeks after LEEP are optimal time points. Finally, LEEP frequency and resection depth are significant risk factors and can be used to screen postmenopausal women at risk for cervical stenosis after LEEP.<\/jats:p>","DOI":"10.1038\/s41598-020-65170-2","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T10:03:39Z","timestamp":1590141819000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A new approach to prevent cervical stenosis in postmenopausal women after loop electrosurgical excision procedure: a randomized controlled trial"],"prefix":"10.1038","volume":"10","author":[{"given":"Jing","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhunan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,22]]},"reference":[{"key":"65170_CR1","doi-asserted-by":"crossref","unstructured":"Penna, C. et al. Laser CO2 conization in postmenopausal age: risk of cervical stenosis and unsatisfactory follow-up. 96, 771\u2013775 (2005).","DOI":"10.1016\/j.ygyno.2004.11.012"},{"key":"65170_CR2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1590\/S1516-31802008000400002","volume":"126","author":"MAC Sampaio","year":"2008","unstructured":"Sampaio, M. A. C. et al. Cervical stenosis following electrosurgical conization. Sao Paulo Medical Journal 126, 209\u2013214 (2008).","journal-title":"Sao Paulo Medical Journal"},{"key":"65170_CR3","first-page":"657","volume":"96","author":"EJ Suh-Burgmann","year":"2000","unstructured":"Suh-Burgmann, E. J., Whall-Strojwas, D., Chang, Y., Hundley, D. & Goodman, A. Risk Factors for Cervical Stenosis After Loop Electrocautery Excision Procedure. Journal of Lower Genital Tract Disease 96, 657\u2013660 (2000).","journal-title":"Journal of Lower Genital Tract Disease"},{"key":"65170_CR4","first-page":"558","volume":"31","author":"JL Brun","year":"2002","unstructured":"Brun, J. L., Youbi, A. & Hock\u00e9, C. Complications, sequellae and outcome of cervical conizations: evaluation of three surgical technics. Journal De Gyn\u00e9cologie Obst\u00e9trique Et Biologie De La Reproduction 31, 558\u2013564 (2002).","journal-title":"Journal De Gyn\u00e9cologie Obst\u00e9trique Et Biologie De La Reproduction"},{"key":"65170_CR5","unstructured":"Shaw, H. A. & Shaw, J. A. Loop Electrosurgical Excision Procedure (LEEP), https:\/\/emedicine.medscape.com\/article\/1998067-overview (2016)."},{"key":"65170_CR6","doi-asserted-by":"crossref","unstructured":"Gentry, D. J., Baggish, M. S., Brady, K., Walsh, P. M. & Hungler, M. S. The effects of loop excision of the transformation zone on cervical length: Implications for pregnancy. 182, 516\u2013520 (2000).","DOI":"10.1067\/mob.2000.104209"},{"key":"65170_CR7","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.7863\/jum.2005.24.11.1483","volume":"24","author":"C Mazouni","year":"2005","unstructured":"Mazouni, C. et al. Transvaginal Sonographic Evaluation of Cervix Length After Cervical Conization. Journal of Ultrasound in Medicine 24, 1483\u20131486 (2005).","journal-title":"Journal of Ultrasound in Medicine"},{"key":"65170_CR8","unstructured":"Mayeaux, E. J. & Cox, J. T. Modern colposcopy textbook and atlas. Lippincott Williams & Wilkins, (2011)."},{"key":"65170_CR9","doi-asserted-by":"crossref","unstructured":"Valle, R. F., Sankpal, R., Marlow, J. L. & Cohen, L. Cervical Stenosis: A Challenging Clinical Entity. Journal of Gynecologic Surgery (2002).","DOI":"10.1089\/104240602762555939"},{"key":"65170_CR10","first-page":"175","volume":"95","author":"JC Boulanger","year":"2001","unstructured":"Boulanger, J. C., Gondry, J., Verhoest, P., Capsie, C. & Najas, S. Treatment of CIN after menopause. 95, 175\u2013180 (2001).","journal-title":"Treatment of CIN after menopause."},{"key":"65170_CR11","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/s00404-002-0439-8","volume":"270","author":"K Hirai","year":"2004","unstructured":"Hirai, K. et al. Occlusion of the external cervical os after conization in a postpuerperal amenorrheic woman. Archives of Gynecology & Obstetrics 270, 64\u201366 (2004).","journal-title":"Archives of Gynecology & Obstetrics"},{"key":"65170_CR12","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/s0301-2115(02)00062-3","volume":"104","author":"S Houlard","year":"2002","unstructured":"Houlard, S. et al. Risk factors for cervical stenosis after laser cone biopsy. Eur J Obstet Gynecol Reprod Biol 104, 144\u2013147, https:\/\/doi.org\/10.1016\/s0301-2115(02)00062-3 (2002).","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"65170_CR13","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/S0029-7844(96)00331-6","volume":"88","author":"JJ Baldauf","year":"1997","unstructured":"Baldauf, J. J., Dreyfus, M. M., Ritter, J., Meyer, P. & Philippe, E. Risk of cervical stenosis after large loop excision or laser conization. Obstetrics & Gynecology 88, 933\u2013938 (1997).","journal-title":"Obstetrics & Gynecology"},{"key":"65170_CR14","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/j.1471-0528.1985.tb01068.x","volume":"92","author":"DMLCR Fellow","year":"1985","unstructured":"Fellow, D. M. L. C. R. et al. Complications of cone biopsy related to the dimensions of the cone and the influence of prior colposcopic assessment. Bjog An International Journal of Obstetrics & Gynaecology 92, 158\u2013164 (1985).","journal-title":"Bjog An International Journal of Obstetrics & Gynaecology"},{"key":"65170_CR15","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.gmit.2014.05.001","volume":"3","author":"S Koyama","year":"2014","unstructured":"Koyama, S. et al. Complete cervical stenosis after conization: Timing for the minimally invasive reconstructive surgery. Gynecology & Minimally Invasive Therapy 3, 57\u201360 (2014).","journal-title":"Gynecology & Minimally Invasive Therapy"},{"key":"65170_CR16","doi-asserted-by":"crossref","unstructured":"Grund, D., Kohler, C., Krauel, H. & Schneider, A. A new approach to preserve fertility by using a coated nitinol stent in a patient with recurrent cervical stenosis 87, 1212.e13\u20131212.e16 (2007).","DOI":"10.1016\/j.fertnstert.2006.10.008"},{"key":"65170_CR17","doi-asserted-by":"crossref","unstructured":"Lacey, J. V. et al. Use of Hormone Replacement Therapy and Adenocarcinomas and Squamous Cell Carcinomas of the Uterine Cervix. 77, 149\u2013154 (2000).","DOI":"10.1006\/gyno.2000.5731"},{"key":"65170_CR18","doi-asserted-by":"publisher","first-page":"9928","DOI":"10.1158\/0008-5472.CAN-08-2051","volume":"68","author":"SH Chung","year":"2008","unstructured":"Chung, S. H., Wiedmeyer, K., Shai, A., Korach, K. S. & Lambert, P. F. Requirement for Estrogen Receptor? in a Mouse Model for Human Papillomavirus-Associated Cervical Cancer. Cancer Research 68, 9928\u20139934 (2008).","journal-title":"Cancer Research"},{"key":"65170_CR19","doi-asserted-by":"publisher","first-page":"2622","DOI":"10.1158\/0008-5472.CAN-07-5266","volume":"68","author":"A Shai","year":"2008","unstructured":"Shai, A., Pitot, H. C. & Lambert, P. F. p53 Loss synergizes with estrogen and papillomaviral oncogenes to induce cervical and breast cancers. Cancer Res 68, 2622\u20132631 (2008).","journal-title":"Cancer Res"},{"key":"65170_CR20","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/01.OGX.0000070130.97707.CD","volume":"58","author":"RF Valle","year":"2003","unstructured":"Valle, R. F., Sankpal, R., Marlow, J. L. & Cohen, L. Cervical Stenois: A Challenging Clinical Entity. Obstetrical & Gynecological Survey 58, 384\u2013385 (2003).","journal-title":"Obstetrical & Gynecological Survey"},{"key":"65170_CR21","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s10147-017-1124-z","volume":"22","author":"Y Tanaka","year":"2017","unstructured":"Tanaka, Y. et al. Predictors for recurrent\/persistent high-grade intraepithelial lesions and cervical stenosis after therapeutic conization: a retrospective analysis of 522 cases. Int J Clin Oncol 22, 921\u2013926, https:\/\/doi.org\/10.1007\/s10147-017-1124-z (2017).","journal-title":"Int J Clin Oncol"},{"key":"65170_CR22","first-page":"672","volume":"48","author":"C Newman","year":"2003","unstructured":"Newman, C. & Finan, M. A. Hysterectomy in women with cervical stenosis: Surgical indications and pathology. Journal of Reproductive Medicine 48, 672\u2013676 (2003).","journal-title":"Journal of Reproductive Medicine"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-65170-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-65170-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-65170-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T11:45:22Z","timestamp":1670327122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-65170-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,22]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["65170"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-65170-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,22]]},"assertion":[{"value":"15 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"8512"}}