Prevalence of HPV infection and cervical lesions among women with pelvic organ prolapse and implications for preoperative evaluation.

BACKGROUND

This study aimed to learn the sketch of HPV infection and cervical lesions including squamous intraepithelial lesions (SIL) and cervical cancer in the population of patients with pelvic organ prolapse and to attempt to provide them with recommendations for preoperative cervical evaluation.

METHODS

This was a retrospective analysis of HPV status, cervical cytology, colposcopic results and histopathology in 1292 patients with Pelvic Organ Prolapse (POP) indicated for hysterectomy over a period of more than 5 years.

RESULTS

Of the 1292 patients, 95 (7.4%) patients tested positive for HPV infection. Among these patients with HPV infection, abnormal Thinprep cytologic test (TCT) results were found in 43 (45.3%) patients and abnormal histopathology were found in 43 (45.3%) patients. Among the 40 patients with normal TCT and positive HPV infection (excluding HPV16/18), 3 cases of unexpected LSIL and one case of unexpected HSIL were identified accidentally. Among POP patients with normal TCT and negative HPV results, 6 cases of LSIL and one case of HSIL, as well as 3 cases of grade I endometrioid endometrial adenocarcinoma and 3 cases of complex atypical hyperplasia of endometrium were accidentally detected in postoperative histopathology.

CONCLUSIONS

POP patients are not at higher risk of HPV infection but women with POP and positive HPV infection are at higher risk of cytologic abnormalities or cervical lesions than non-POP population. Colposcopy is recommended as part of the preoperative examination of POP patients to rule out cervical lesions, especially those with HPV infection.