Search

Objective: To investigate the efficacy and safety of alprostadil cream in management of female sexual arouse disorder (FSAD), and its appropriate dose for clinical prescription., Methods: The volunteers were assigned randomly to four groups which received alprostadil cream in different dosage (500 μg, 700 μg and 900 μg) or placebo cream, respectively. The cream was applied to the clitoris and G-spot before coitus. The efficacy was assessed by comparing the satisfactory rate of sexual arousal, the score of female sexual function index (FSFI) and female sex disorder scale (FSDS) and the general appraised question (GAQ) before and after the treatment. The safety was evaluated by the adverse effects that appeared including symptoms, physical and biochemical examination., Results: Totally, 400 women enrolled in this study with 374 assigned to the group for efficacy evaluation and 387 cases to the group for safety analysis. No significant difference was found among the four groups in the demographic characters and sexual baseline. The increase of satisfactory percentage of sexual arousal in the four groups (placebo, 500 μg, 700 μg and 900 μg) was 22.63%, 36.67%, 34.01%, and 44.29%, respectively (P<0.05), and the increase was statistically higher in the 900 μg group than in the placebo group (P<0.0167). The elevated FSFI score above the baseline in the treatment groups (900 μg 22.89, 700 μg 21.69, and 500 μg 20.71) were higher than that in the placebo group (14.68, P<0.05), while the reduced FSDS score below the baseline (900 μg 25.97, 700 μg 21.98, and 500 μg 20.27) were higher than that of the placebo (17.60, P<0.05). No significant difference was found in the four groups in GAQ (P=0.054). The main common adverse effect was topical stimulation. No adverse effect was reported in physical and biochemical examination, electrocardiogram (ECG) or Thinprep cytologic test (TCT)., Conclusion: Alprostadil cream can treat female sexual arousal disorder effectively with the maximum effect at the dose of 900 μg and without significant adverse effect except for mild topical stimulation.

Objective: To investigate the clinical significance of atypical squamous cells (ASCUS) and low-grade squamous intraepithelial lesions (LSIL)., Methods: A total of 800 patients cytologically diagnosed with ASCUS and LSIL were referred for colposcopy. The histopathology diagnosis undergoing colposcopic biopsy, endocervical curettage (ECC), cervical loop electrosurgical excision procedure (LEEP) were analyzed. Using pathology as gold criterion, the sensitivity, specificity and positive predictive value of colposcopy to detect cervical lesions and cervical cancer were measured. The follow-up results were recorded., Results: (1) Among the 405 patients with ASCUS, the percentage with chronic cervicitis was 57.04%, LSIL was 34.81%, HSIL was 3.95%, otherwise 2 cases (0.49%) of microinvasive cervical cancer and 15 cases (3.70%) of vulvar intraepithelial neoplasia (VIN) were found respectively. Among the 395 patients with LSIL, the percentage with chronic cervicitis was 34.18%, LSIL was 50.89%, HSIL was 10.38%, 2 cases (0.51%) of microinvasive cervical cancer, 1 case (0.25%) of vulva squamous cancer and 15 cases (3.80%) of VIN was identified respectively. (2) The impression undergoing colposcopy was consistent with the histologically diagnosis in 637 of 800 cases (79.63%). The sensitivity, specificity and positive predictive value was 96.17%, 58.41% and 73.34% respectively. (3) All patients with HSIL or above regressed to normal after 1 year of follow-up. 501 of 738 patients with chronic cervicitis, LSIL and VIN were followed up more than 1 year., Conclusion: ASCUS and LSIL does not represent a single biologic entity; it subsumes changes that are unrelated to neoplasia as well as findings that suggest the possible presence of underlying Cervical intraepithelial neoplasia (CIN) and rarely carcinoma. Thorough evaluation using colposcopy will detect early not only the histological cervical HSIL and cervical cancer, but also VIN and vulvar squamous cancer. Colposcopy is a viable option in management patients with ASCUS/LSIL.