[Is hysterectomy required during vaginal reconstructive pelvic surgery? About histopathological results].

OBJECTIVES

To evaluate the rate of pre-cancerous and cancerous endometrial lesions in hysterectomy during vaginal reconstructive pelvic surgery.

PATIENTS AND

METHODS

In this retrospective and continuous study, a vaginal procedure including reconstructive pelvic surgery with vaginal mesh, hysterectomy and adnexectomy was performed in 152 patients between April 2001 and January 2006. An ultrasonography evaluation was done before surgery. A histopathological analysis of uterus, ovaries and tubes was also performed.

RESULTS

In the analysis of 136 cases, precancerous and cancerous lesions have been diagnosed while ultrasonography or cervical smear were normal: 2 (1.4%) endocervical dysplasia, 1 (0.7%) cervical epidermoid carcinoma, 10 (7.35%) endometrial complex non-atypical hyperplasia, 7 (5.1%) endometrial atypical hyperplasia and 2 (1.4%) endometrioid endometrial carcinoma. There was not any cancerous lesions in tubes or ovaries. At 10months, mesh exposure was low at 2.9% (four cases).

DISCUSSION AND

CONCLUSION

The important rate of cancerous and precancerous lesions raise the question of hysterectomy or hysteroscopy and endometrial biopsy in case of uterine preservation during a vaginal reconstructive pelvic surgery.