Prevention of cervical stenosis after surgical treatment of cervical intraepithelial neoplasia in the concept of early detection of invasive cervical cancer

Purpose of the study. To evaluate the effectiveness of a domestic bioregenerant – the heterogeneous implantable gel composition Sphero®GEL – for the prevention of cervical stenosis following organ-­sparing surgical treatment of cervical intraepithelial neoplasia (CIN).

Patients and methods. The pilot study included 15 patients with cervical intraepithelial neoplasia (CIN) of varying severity after radiosurgical resection of the cervix. On the 14th postoperative day, they received sequential injections into the cervical area of the heterogeneous implantable gel composition Sphero®GEL LIGHT 2.0 No. 1, followed 7 days later by Sphero®GEL MEDIUM 2.0 No. 1. The injections were administered using a bolus technique multifocally across the entire wound surface of the exocervix and multipositionally along the entire circumference and length of the endocervical canal.

Results. Postoperative administration of the injectable heterogeneous implantable Sphero®GEL composition promoted accelerated and effective regeneration with restoration of the cervical anatomical structure after radiosurgical resection. Complete epithelialization was recorded in 13/15 (86.6 %) patients after 1 month, which contributed to the preservation of cervical canal patency and the absence of external os stricture in 15/15 (100.0 %) patients at the 6‑month follow-up. The mean diameter of the cervical canal was 6.33 ± 2.31 mm by Hegar dilator and 6.0 ± 1.0 mm (min. 5, max. 8) by ultrasound cervicometry. The degree of vaginal purity significantly improved from 2.2 ± 0.45 to 1.3 ± 0.46 (p < 0.05) during the course of treatment.

Conclusion. Thus, the use of the domestic bioregenerant and extracellular matrix mimetic – the heterogeneous implantable gel composition Sphero®GEL – in the postoperative period can be considered a promising approach for the prevention of cervical stenosis after organ-­sparing surgical treatment of cervical intraepithelial neoplasia. This provides a basis for the implementation of adequate monitoring and for solving a number of current problems in oncology.

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