The incidence of concomitant precancerous lesions in cases who underwent hysterectomy for prolapse

Abstract

Aim: The aim of the study was is to assess the incidence of unexpected gynecological cancers and pre-cancerous lesions following hysterectomy for pelvic organ prolapse to better understand the risks of uterine sparing surgery. Material and Method: This was a retrospective analysis of histopathology findings after hysterectomy for uterine prolapse surgery who underwent preoperative diagnostic work including cervical cytology, transvaginal ultra-sonography and endometrial histopathological examination for a high risk group (Postmenopausal women with an endometrial thickness of ≥5 mm and premenopausal women with abnormal bleeding). Patients with a history of endometrial, cervical and/or adnexal precancerous or cancerous pathological conditions and with incomplete medical records were excluded. Results: Results were taken from 106 women who underwent hysterectomy. The abdominal route was used in 22 cases (21.7 %), the vaginal route in 82 patients (77.4 %) and laparoscopic-assisted vaginal route in two (1.9 %) women. Oophorectomy was performed in 35 (33 %) cases. None of the patients had malignant histopathology specimens from hysterectomy. Total premalignant pathology incidence was 7.5 % (8/106). Six (5.7%) patients had simple endometrial hyperplasia and 2 patients (1.9 %) had cervical intraepithelial neoplasia. Discussion: The incidence of unexpected endometrial, cervical or ovarian malignancy among women who underwent hysterectomy after preoperative diagnostic workup including transvaginal ultrasonograhy, endometrial pathological examination to high risk cases was negligible. The inclusion of low risk endometrial and cervical precancerous lesions increased the incidences. Our results could provide precious data to extrapolate to similar populations with uterine prolapse who desire surgical correction sparing uterus.