Microwave therapy for cervical ectropion

In western countries, cervical ectropion or erosion caused by the movement of columnar epithelium onto the vaginal portion of the cervix is considered a normal physiological process not requiring intervention. In China, however, cervical ectropion is considered as one of the most common types of chronic cervicitis and is often treated. One of the topical treatments widely used is microwave tissue coagulation (MTC). From Chinese databases, the authors identified 131 potential randomised controlled clinical trials (RCTs) that compared microwave therapy to no treatment or other treatments. Only three of these studies involving a total of 540 participants were identified as RCTs. Two studies (420 participants) compared MTC versus laser, and one study (120 participants) compared MTC with an interferon-alpha suppository. The follow-up period of the RCTs was adequate. None of the studies assessed relief of symptoms or quality of life and satisfaction, which are very important to women. The authors of the review considered that they could not answer the review question about the appropriate use of microwave therapy as only these three low quality RCTs were found. Although the trials showed improved appearance of the cervix with microwave treatment compared with the control therapy, it was not possible to ascertain whether the women were symptomatic before treatment. The review protocol also required participants to be symptomatic with mucopurulent discharge or to have contact bleeding before treatment. At present, intervention for inflammatory cervical ectropion is still controversial.