You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Using amino-cerv after cervical LEEP.
Abstract 1:
OBJECTIVE To evaluate the ability of Amino-Cerv to promote healing of the cervix following loop electrical excision procedure ( LEEP ) of the cervix for cervical intraepithelial neoplasia . STUDY DESIGN A r and omized study was conducted on 48 women in a private office setting . Patients were divided into two groups , to use or not use Amino-Cerv intravaginally for two weeks after the procedure . Statistical analysis of the findings were performed using the chi 2 test . RESULTS Twenty of 24 ( 83 % ) of women using Amino-Cerv had completely healed tissue at four weeks , whereas 12 of 24 ( 50 % ) in the untreated group had healed tissue at four weeks . Findings were not statistically significant at two weeks but were statistically significant ( P < .005 , power = .55 ) at four weeks after the procedure . CONCLUSION Amino-Cerv after LEEP of the cervix promotes healing


Title 2:
A randomized trial of Citanest with Octapressin for relief of pain associated with laser vaporization of the cervix
Abstract 2:
Summary . Fifty women undergoing laser vaporization of the cervix for cervical intraepithelial neoplasia were r and omly allocated to one of two groups . In one group the patients received no anaesthesia , in the other the ectocervix was infiltrated with 2 ml of Citanest with Octapressin ( prilocaine 3 % with 0.03 i.u./ml . of felypressin ) immediately before the procedure . The pain experienced by each group was assessed immediately after treatment by visual analogue and verbal rating scales . The pain experienced by those women receiving local anaesthesia was significantly reduced as assessed by the visual analogue scale ( P = 0.011 ) and this reduction was not quite significant by the verbal rating scale ( P = 0.06 ) . The Citanest group had less troublesome bleeding but the difference in bleeding between the two groups was not significant


Title 3:
A comparison of the side effects of prilocaine with felypressin and lignocaine with adrenaline in large loop excision of the transformation zone of the cervix: results of a randomised trial
Abstract 3:
Objective To test the hypothesis that prilocaine with felypressin causes fewer side effects than lignocaine with adrenaline when performing large loop excision of the transformation zone of the cervix


Title 4:
A randomized study of local or general anesthesia for laser conization of the cervix
Abstract 4:
Abstract . Laser Conization of the cervix was performed in both inpatient and outpatient setting s with either local or general anesthesia . All of the patients included had abnormal cervical smears , abnormal colposcopic findings and were allocated to one of two groups , A and B. Patients in group A had general anesthesia while patients in group B had only local anesthesia . A st and ard operative technique , was used and all patients had estimation of blood loss , recording of operative time , surgical suite time , anesthesia induction time , and assessment of postoperative pain and morbidity . Statistical analysis was performed using the student t-test . We concluded that laser conization of the cervix can be performed more cheaply with local anesthesia than with general anesthesia and with little discomfort , less nausea , and vomitting


Title 5:
A trial that compares Monsel's paste with ball electrode for hemostasis after loop electrosurgical excision procedure.
Abstract 5:
OBJECTIVE The purpose of this study was to compare Monsel 's paste with fulguration with ball electrode for hemostasis after loop electrosurgical excision procedure . STUDY DESIGN One hundred healthy women were assigned r and omly by computer-generated r and om numbers to ball electrode or thickened Monsel 's paste for hemostasis after loop electrosurgical excision procedure . Patients rated pain during hemostasis using a visual analog scale . At 2 weeks , postprocedural vaginal discharge was rated on a Likert scale . Pathology was review ed for dysplasia grade and margin status . Recurrent dysplasia on repeat Papanicolaou tests was noted . RESULTS Six patients ( 2 Monsel 's and 4 fulguration ) required an alternate method of hemostasis . Patient demographics , postprocedural discharge , and recurrent dysplasia were comparable between the 2 groups . Visual analog scale scores and hemostasis time were significantly higher in the fulguration group . Estimated blood loss , although higher in the fulguration group , was not significant between groups . CONCLUSION Monsel 's paste and fulguration with ball electrode appear be equally effective as hemostatic agents after loop electrosurgical excision procedure


Title 6:
Effects of Ball Cauterization Following Loop Excision and Follow‐Up Colposcopy
Abstract 6:
Objective To investigate whether central diathermy ball cauterization after loop excision affects satisfactory colposcopy at follow-up . Methods One hundred one consecutive women with the squamocolumnar junction visible at the ectocervix scheduled for loop excision were assigned alternately into two groups . In group A , diathermy ball cauterization was applied to the entire crater following excision . In group B , cauterization was avoided in a 2–3-mm zone around the new os . The women were re-examined 4 months postoperatively by colposcopy and microcolpohysteroscopy with specific intention to identify the location of the squamocolumnar junction . The examiners performing colposcopy and microcolpohysteroscopy were not aware of each other 's interpretation , or of the method of cauterization used . Results Follow-up colposcopy was satisfactory in 12 women in group A ( 24 % ) and 47 women in group B ( 92.2 % ) ( P < .001 ) . Forty-three women ( 86 % ) in group A and ten in group B ( 19.6 % ) had the squamocolumnar junction partly or fully located within the cervical canal ( P < .001 ) .  Microcolpohysteroscopy  located the squamocolumnar junction at a mean depth of 4.5 ± 2.4 mm ( ± st and ard deviation [ SD ] ) in the women in group A and 1 ± 0.9 mm in group B ( P < .001 ) . Microcolpohysteroscopy  could not be performed in 13 women in group A ( 26 % ) and one woman in group B ( 2 % ) ( P < .001 ) . Conclusion Diathermy ball cauterization at the new cervical os after loop excision results in a shift of the squamocolumnar junction toward the endocervical canal , and predisposes to cervical stenosis , thereby decreasing satisfactory colposcopy rates


Title 7:
Use of an antifibrinolytic agent (tranexamic acid) and lateral sutures with laser conization of the cervix.
Abstract 7:
One hundred forty patients who underwent laser conization and 220 patients who underwent laser miniconizations  were prospect ively r and omized into two study groups . One treatment group was given antifibrinolytic therapy in the form of tranexamic acid ( Cyklokapron , KabiVitrum , Sweden ) intraoperatively and for 14 days postoperatively . The other group did not receive antifibrinolytic therapy . In the group of 68 patients with laser conizations who were given antifibrinolytic therapy , no postoperative hemorrhages occurred , whereas there were eight such hemorrhages in 72 conizations ( 11 % ) in the untreated patients . This difference is statistically significant ( P = .004 , Fisher exact test for two proportions ) . Also , for laser miniconization , the frequency of postoperative hemorrhage was almost halved , from 9.1 % in 110 patients not receiving antifibrinolytic therapy to 5.5 % in the 110 treated patients . The use of lateral cervical sutures did not reduce the frequency of postoperative hemorrhage at laser conization in the present study


Title 8:
Hemostasis and Cold Knife Cone Biopsy: A Prospective Randomized Trial Comparing a Suture Versus Non‐Suture Technique
Abstract 8:
Two methods of obtaining hemostasis after cold knife cone biopsy were compared in a prospect i ve r and omized trial involving 200 patients . One method relied primarily on hemostatic sutures , and the other involved the use of a styptic solution ( Monsel 's solution ) and vaginal pack , thus avoiding the use of sutures altogether . The short- and long-term morbidity in these two groups were compared and 12-month follow-up was completed . The use of sutures did not reduce the incidence of primary hemorrhage . Secondary hemorrhage was twice as frequent in the suture group , although this trend did not quite reach statistical significance . During long-term follow-up , significantly more patients in the suture group developed menstrual symptoms , cervical stenosis , and unsatisfactory colposcopy , requiring further operative intervention as a result


Title 9:
Does application of Monsel's solution after loop diathermy excision of the transformation zone reduce post operative discharge? Results of a prospective randomised controlled trial
Abstract 9:
Since its initial description by Prendiville et al. ( 1989 ) , loop diathermy excision of the transformation zone has become a common method for the local treatment of colposcopically detected abnormalities of the transformation zone . A number of studies including Luesley et al. ( 1990,1992 ) , have analysed patient symptoms retrospectively and noted that these were in the main related to  vaginal discharge and bleeding  of short duration . We report here a prospect i ve study objective ly documenting patient bleeding and discharge following loop diathermy . Monsel ’s solution has been shown to be an effective haemostat at cone biopsy ( Gilbert etal . 1989 ) ; we determined to see if Monsel ’s solution applied following loop diathermy would reduce vaginal discharge


Title 10:
The Effect of Tranexamic Acid (Amca) On Postoperative Bleeding After Conization
Abstract 10:
A double blind r and omized trial was made to ascertain the effect of tranexamic acid ( AMCA ) ( Cyklo‐kapron ® ) on the postoperative blood loss after conization . The case material consisted of 50 women referred to the clinic because of dysplasia or non‐invasive cancer of the cervix . Five patients were excluded for various reasons . The treatment started in the evening of the day of operation and was continued for another 12 days , the dose being three tablets every 8 hours , corresponding to 4.5 g of tranexamic acid daily when the active drug was given . During the first 7 postoperative days , when the patients were in hospital , the blood losses were determined quantitatively . Prophylactic treatment with tranexamic acid  reduced the postoperative blood loss as compared with the placebo group , the blood losses being 23 ± 3.2 ml and 79 ± 20.4 ml respectively . Sudden profuse bleeding postoperatively , requiring remedial measures , occurred in 7 patients , all in the placebo group . With the exception of 1 patient in the placebo group , who complained of nausea , no side effects were recorded


Title 11:
Do routine antibiotics after loop diathermy excision reduce morbidity?
Abstract 11:
Objective To evaluate whether routinely giving an antibiotic after loop diathermy excision of the cervical transformation zone reduced post‐operative vaginal loss


Title 12:
Bleeding After Loop Electrosurgical Excision Procedure Performed in Either the Follicular or Luteal Phase of the Menstrual Cycle: A Randomized Trial
Abstract 12:
OBJECTIVE To estimate the perioperative or postoperative bleeding rates after treatment of cervical intraepithelial neoplasia by loop electrosurgical excision procedure in either the follicular or luteal phase of the menstrual cycle . METHODS A r and omized controlled trial was carried out to compare the outcomes in terms of primary and secondary hemorrhage between patients treated by loop electro‐surgical excision procedure during either the follicular ( 30 women ) or luteal phase ( 30 women ) of the menstrual cycle . The two groups did not differ in terms of mean age , grade of cervical intraepithelial neoplasia , depth of excision , parity , and duration of menses . Primary outcome measures included the objective and subjective assessment of intra‐operative and postoperative bleeding . RESULTS Women treated during the luteal phase of the menstrual cycle experienced significantly more postoperative bleeding than women treated during the follicular phase , as assessed by the fall in hematocrit levels ( P < .001 ) and subjective reports . Intraoperative bleeding was judged to be more severe in women treated during the luteal phase of the cycle by a single , blinded colposcopist ( P = .02 ) . These women also experienced higher levels of anxiety postoperatively , which result ed in more consultations with medical staff ( P = .007 ) . CONCLUSION The use of loop electrosurgical excision procedure to treat cervical intraepithelial neoplasia results in less bleeding if performed during the follicular phase of the menstrual cycle


Title 13:
THE HEMOSTATIC EFFECT OF TRANEXAMIC ACID IN CONISATIO COLLI UTERI
Abstract 13:
Abstract . To evaluate the inhibitory effect of tranexamic acid ( AMCA ) on increased fibrinolyctical activity in connection with conisatio colli uteri we have carried out a r and omized , double‐blind study with patients operated upon partly with an open method of operation ( 80 patients ) and partly with modified Sturmdorff sutures ( 150 patients ) . In connection with the open method the frequency of late bleeding decreased from . 17.5 % to 2.5 % , which is significant . The corresponding decrease in connection with the other method was from 10.7 % to 4.1 % . This material was not sufficiently large to verify significance . The side effects of the prophylactic treatment with AMCA were few
Bleeding associated with surgery of the cervix appears to be reduced by vasopressin , used in combination with local anaesthetic .
Tranexamic acid appears to be beneficial after knife and laser cone biopsy .
There is some evidence that haemostatic suturing has an adverse effect on blood loss , cervical stenosis and satisfactory colposcopy