Utility of preoperative endometrial assessment in asymptomatic women undergoing hysterectomy for pelvic floor dysfunction. Journal Article


Authors: Ramm, O.; Gleason, J. L.; Segal, S.; Antosh, D. D.; Kenton, K. S.
Article Title: Utility of preoperative endometrial assessment in asymptomatic women undergoing hysterectomy for pelvic floor dysfunction.
Abstract: INTRODUCTION AND HYPOTHESIS: Uterine morcellation during laparoscopy for pelvic floor repair has prompted adoption of uterine screening tests by some surgeons. We report a case series of uterine malignancy incidentally diagnosed at the time of pelvic floor surgery. METHODS: We reviewed records from patients undergoing hysterectomy for pelvic organ prolapse (POP) and/or urinary incontinence (UI) from January 2004 to December 2009 and abstracted preoperative screening trends and final pathologic diagnoses. RESULTS: Of the 708 women in the study, 125 (18%) had preoperative endometrial biopsy (EB), 43 (6%) had pelvic ultrasound (US), and 21 (3%) had EB and US. Surgical route included vaginal (58%), abdominal (23%), and laparoscopic (18%). Most (97.1%) final pathologic diagnoses were benign. Five cancers (0.6%) were detected; four of these women had normal preoperative screening, including EB (2), US (1), or both tests (1). CONCLUSIONS: Screening with EB + US was found to be ineffective in our cohort of patients due to the low prevalence of undetected uterine cancer in asymptomatic women planning POP/UI surgery.
Keywords: Female; Humans; Middle Aged; Obstetrics and Gynecology; Retrospective Studies; IM; Biopsy; Hysterectomy; Preoperative Period; Incidental Findings; Laparoscopy/mt [Methods]; Endometrial Neoplasms/di [Diagnosis]; Endometrial Neoplasms/pa [Pathology]; Endometrial Neoplasms/su [Surgery]; Pelvic Floor/pa [Pathology]; Pelvic Floor/su [Surgery]; Pelvic Floor/us [Ultrasonography]; Pelvic Organ Prolapse/pa [Pathology]; Pelvic Organ Prolapse/su [Surgery]; Pelvic Organ Prolapse/us [Ultrasonography]; Urinary Incontinence/pa [Pathology]; Urinary Incontinence/su [Surgery]; Urinary Incontinence/us [Ultrasonography]; Uterine Neoplasms/di [Diagnosis]; Uterine Neoplasms/pa [Pathology]; Uterine Neoplasms/su [Surgery]
Journal Title: International Urogynecology Journal
Volume: 23
Issue: 7
ISSN: 0937-3462
Publisher: Unknown  
Journal Place: England
Date Published: 2012
Start Page: 913
End Page: 917
Language: English
DOI/URL:
Notes: ID: 12624; Status: MEDLINE; Publishing Model: Journal available in: Print-Electronic Citation processed from: Internet; NLM Journal Code: cl5, 9514583, 101567041