Post-coital vaginal douching is risky for non-regression of low-grade squamous intraepithelial lesion of the cervix

• Published in: Gynecologic oncology 2011-03, Vol.120 (3), p.449-453
• Main Authors: Chu, Tang-Yuan, Hsiung, Chao Agnes, Chen, Chi-An, Chou, Hung-Hsueh, Ho, Chih-Ming, Chien, Tsai-Yen, Chang, Hui-Ju, Chou, Cheng-Yang, Liou, Jui-Der, Kan, Yuen-Yee, Hsieh, Chang-Yao
• Format: Article
• Language: English
• Subjects: Adult; Carcinoma, Squamous Cell - etiology; Carcinoma, Squamous Cell - virology; Cervical Intraepithelial Neoplasia - etiology; Cervical Intraepithelial Neoplasia - virology; Cohort Studies; Coitus; Colposcopy; Cross-Sectional Studies; Female; Hematology, Oncology and Palliative Medicine; Human papillomavirus; Humans; Low-grade squamous intraepithelial lesion; Obstetrics and Gynecology; Papillomaviridae - classification; Papillomaviridae - isolation & purification; Prospective Studies; Risk Factors; Therapeutic Irrigation - adverse effects; Uterine Cervical Neoplasms - etiology; Uterine Cervical Neoplasms - virology; Vaginal douche
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2010.11.006

Abstract Background Vaginal douching is a common practice worldwide. Its effect on the natural history of the early lesion of human papillomavirus (HPV) infection, low-grade squamous intraepithelial lesion (LSIL), is unknown. Methods In a prospective nation-wide cohort ( n = 1332), epidemiological variables including habit of vaginal douching after intercourse and outcomes of LSIL were studied. Colposcopy-confirmed LSIL women ( n = 295) were followed every 3 months. Parameters of HPV infection, sexual behavior, personal hygiene and environmental exposures were compared with the follow-up outcomes. Results There was a 15% chance of HSIL co-existing with the LSIL cytology result. Eight percent of colposcopy-confirmed LSIL were found with HSIL in 1 year. With a follow-up of up to 36 months, 83% LSIL regressed, 11% progressed and 6% persisted. The mean time (95% CIs) to regression and progression were 5.2 (4.7–5.8) and 8.0 (5.8–10.3) months, respectively. Risk factors of the non-regression of LSIL included HPV prevalence on enrollment, habit of vaginal douching after intercourse with a hygiene product and non-regular Pap screening, with odd ratio of 4.4 (1.9–10.3), 3.14 (1.04–9.49) and 2.12 (1.24–3.62), respectively. HPV prevalence and vaginal douching also conferred a slower regression of LSIL (8.0 vs. 4.1 months, P < .001 and 8.0 vs. 5.6 months, P = 0.02, respectively). Conclusion The study disclosed a transient but warning nature of cytological LSIL. Practicing of vaginal douching after intercourse, especially with hygiene products, is associated with non-regression of LSIL.