Prevalence of malignant uterine pathology in utero-vaginal prolapse after vaginal hysterectomy
Journal Title: Pelviperineology - Year 2020, Vol 39, Issue 4
Abstract
Objective: The aim of this study was to establish the prevalence of malignant uterine pathology after vaginal hysterectomy (VH) due to asymptomatic uterovaginal prolapse. Materials and Methods: A descriptive observational cross-sectional study including 110 women with VH indication for hysterocele greater than or equal to POP-Q stage II with negative Pap smear still valid, and with normal transvaginal ultrasound in the past year. Patients with abnormal uterine bleeding or suspected premalignant or malignant uterine disease were excluded. All participants signed an informed consent document. The mean age was 64 year old (SD ±8.84), 85.5% of them being menopausal. Results: 78.2% of histopathological findings did not present any uterine pathology. Endometrial hyperplasia without atypia was found in 11 cases (10%) and endometrial polyps without atypia in 12 cases (10.9%). There were no cases of hyperplasia with atypia. Uterine leiomyoma (25.5%) and focal and diffuse adenomyosis (23.6%) were also found. Only one case had endometrial cancer (0.9%) and there were no cases of cervical cancer. Conclusion: The risk of uterine malignancy after VH due to utero-vaginal prolapse is low. This result may have been affected by the assessment in the year prior to surgery, in keeping with recommendations of ruling out abnormal uterine bleeding and considering Venous thromboembolism (VTE) assessment and cytology of the cervix in the preoperative period. Information regarding the risk of premalignant and malignant pathology of the uterus must be included in the pre-surgery information in the form of a consent document.
Authors and Affiliations
EDGARDO CASTILLO-PINO, VALENTINA ACEVEDO, NATALIA BENAVIDES, VALERIA ALONSO, WASHIGNTON LAURÍA
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