Incidental gynaecological malignancy in women who underwent hysterectomy for utero-vaginal prolapse: a 3-year institutional case study

Abstract

Background: Pelvic organ prolapse is common is almost 50% of women over the age of 50years. The objective of the present study was to estimate the number of incidental gynaecological malignancies in women who underwent hysterectomy for utero-vaginal prolapse.Methods: 354 women who presented with asymptomatic utero-vaginal prolapse were included in this study. Women who were symptomatic with bleeding per vaginum, lower abdominal pain or excessive white discharge and preoperative screening tests such as VIA/VILI, colposcopy, Pap smear and radio-imaging showing any gynaecological lesions were excluded from this study.Results: Histopathological examination of the hysterectomy specimen showed premalignant lesion in 13 cases accounting to 3.7% (11 cases of CIN I, 1 case of CIN II, 1 case of CIN III) and malignant lesions in 5cases accounting for 1.4% (4 cases of endometrial adenocarcinoma and 1 case of cervical squamous cell carcinoma).Conclusions: Asymptomatic women with utero-vaginal prolapse may have pre-existing premalignant and malignant lesions. Therefore, all women undergoing hysterectomy should be preoperatively screened with transvaginal ultrasound, endometrial biopsy and pap smear to rule out malignancy, as the management differs for patients with co-existing gynecological malignancies.

Prevalence of occult gynecological cancer in women undergoing surgeries for benign indications in a tertiary healthcare center of Chhattisgarh

“…Secondly, the surgeon may prefer one route over the other based on their expertise and they may systematically select the patient for different types of surgeries based on their risk profile. 13,14 Among patients with occult premalignant and malignant lesions only 11.1% (2 women) had TAH with bilateral salpingo-oophorectomy and 5.5% (1 woman) women had TAH with right salpingo-oophorectomy and these women had associated ovarian pathology or belonged to high-risk group. There is a decreasing trend of bilateral salpingooophorectomy all over the world which was mainly done in order to decrease risk of ovarian cancer and the age limit was 45 year.…”