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The incidence and risk factors of occult malignancy in patients receiving vaginal hysterectomy for pelvic organ prolapse

Authors
 Soo Min Ryu  ;  Jeong Soo Cho  ;  Mi Kyung Kong  ;  Sang Wook Bai 
Citation
 INTERNATIONAL UROGYNECOLOGY JOURNAL, Vol.34(11) : 2719-2724, 2023-11 
Journal Title
INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN
 0937-3462 
Issue Date
2023-11
MeSH
Endometrial Neoplasms* / epidemiology ; Endometrial Neoplasms* / etiology ; Endometrial Neoplasms* / surgery ; Female ; Humans ; Hysterectomy, Vaginal* / adverse effects ; Incidence ; Pelvic Organ Prolapse* / epidemiology ; Pelvic Organ Prolapse* / etiology ; Pelvic Organ Prolapse* / surgery ; Retrospective Studies ; Risk Factors
Keywords
Malignant uterine pathology ; Pelvic organ prolapse ; Uterine-conserving surgery ; Vaginal hysterectomy
Abstract
Introduction and hypothesis: The aim of this study was to assess the incidence and risk factors for premalignant and malignant pathology in patients receiving vaginal hysterectomy (VH) and pelvic floor repair (PFR) for pelvic organ prolapse (POP).

Methods: We performed a retrospective cohort study of pathological results after VH and PFR of 569 women at our institution from January 2011 through December 2020. Age, body mass index (BMI), POP-Q stage, and preoperative ultrasound results were evaluated as risk factors for occult malignancy.

Results: Six of the 569 patients (1.1%) had unanticipated premalignant uterine pathology and 2 (0.4%) had unanticipated malignant uterine pathology (endometrial cancer). There was no significant difference in the incidence of premalignant or malignant uterine pathology according to age, BMI, and POP-Q stage. However, if endometrial pathology is confirmed on preoperative ultrasonography, the probability of confirming malignant pathology increases (OR 4.63; 95% CI 1.84-51.4; p=0.016).

Conclusion: The incidence of occult malignancy during VH for POP was significantly lower than that found in hysterectomy owing to benign disease. In the case of POP patients, for whom uterine-conserving surgery is not absolutely contraindicated, it can be performed. However, if endometrial pathology is confirmed by preoperative ultrasonography, uterine-conserving surgery is not recommended.
Full Text
https://link.springer.com/article/10.1007/s00192-023-05576-4
DOI
10.1007/s00192-023-05576-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kong, Mi Kyung(공미경)
Ryu, Soomin(류수민)
Bai, Sang Wook(배상욱) ORCID logo https://orcid.org/0000-0001-7724-7552
Cho, Jeong Soo(조정수)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197408
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