Monsel's paste after LEEP: good results, low cost.(Gynecology)(loop electrosurgical excision procedure)

SCOTTSDALE, ARIZ. -- Monsel's paste produced less pain and worked faster than fulguration by a ball electrode in a randomized clinical trial comparing the two methods for achieving hemostasis after the loop electrosurgical excision procedure; the statistical advantages were not clinically significant, however.

"It basically comes down to either method is acceptable," Dr. Gary H. Lipscomb said at the annual meeting of the Central Association of Obstetricians and Gynecologists.

Dr. Lipscomb, director of the division of gynecologic specialties at the University of Tennessee Health Science Center in Memphis, and his coinvestigators compared the two methods in 100 women who underwent the loop electrosurgical excision procedure (LEEP) for cervical dysplasia.

They randomized the women by computer-driven numbers placed in sealed envelopes that were opened only after each patient agreed to participate in the study. Six patients (two randomized to Monsel's paste and four to ball electrode) required additional hemostasis with an alternative method.

In 47 women treated with Monsel's paste, physicians were able to stop bleeding in 118.7 seconds on average. Fulguration with 50 watts of modulated current passing through a 5-mm ball electrode took significantly longer at 207.5 seconds for 53 women in the other cohort. Dr. Lipscomb said the time difference, being little more than a minute, did not matter clinically.

Similarly, even though women randomized to Monsel's paste had ...