Is transvaginal ultrasound a worthwhile investigation for women undergoing vaginal hysterectomy?

Srikrishna, Sushma; Robinson, David; Cardozo, Leonardo Leite; Yazbek, Joseph

doi:10.1080/01443610802149954

Cited by 8 publications

(4 citation statements)

References 13 publications

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“…Also the absence of ovarian cancer in our series is consistent with previous reports underlining the usefulness of transvaginal ultrasonography as an investigation prior to prolapse surgery [2,17]. In a study that evaluates the usefulness of transvaginal ultrasonography prior to vaginal hysterectomy Srikrishna et al found gynecological pathology in 46.6% of patients and changed the planned management in 2.9% of cases due to large fibroids and ovarian cysts [18]. The strengths of our study come from the single institution data with all cases evaluated with transvaginal ultrasoud, cervical cytology and endometrial sampling in cases of necessity.…”

Section: Discussionsupporting

confidence: 80%

The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse

Aydın¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Çalışmanın amacı pelvik organ prolapsusu nedeniyle histerektomi yapılanlarda beklenmedik jinekolojik kanseri ve prekanseröz lezyonların insidansını belirlemek böylece uterus koruyucu cerrahinin risklerini anlayabilmektir. Gereç ve Yöntem: Bu uterin prolapsus cerrahisi öncesi servikal sitoloji, transvajinal ultrasonografi ve yüksek risklilere (endometrial kalınlığı ≥5 mm olan postmenopozal kadınlar ve anormal uterin kanamalı premenopozal kadınlar) uygulanan endometrial histopatolojik incelemenin yer aldığı preoperatif değerlendirme yapılan histerektominin histopatolojik bulgularının retrospektif analizidir. Endometrial, servikal veya ovaryan kanser veya prekanseröz lezyon öyküsü bulunan hastalar ve eksik tıbbı kayıtları olan kadınlar çalışma-ya dahil edilmedi. Bulgular: Histerektomi yapılan 106 kadın vardı. Abdominal yol 22 (%21.7) vakada, vajinal yol 82 (%77.4) vakada ve laparoskopinin asiste ettiği vajinal histerektomi iki (%1.9) vakada kullanıldı. Vakaların 35' inde (%33) ooferektomi uygulandı. Histerektomi materyallerinden hiçbirinde malign histopatoloji tespit edilmedi. Premalign patoloji insidansı %7.5 (8/106) olarak bulundu. Altı kadında (%5.7) basit atipisiz endometrial hiperplazi tespit edilirken 2 kadında (%1.9) servikal intraepitelyal neoplazi tespit edildi. Tartışma: Transvajinal ultrasonografi ve yüksek riskli vakalara endometrial patolojik incelemenin dahil olduğu preopartif değerlendirme sonrasında histerektomi yapılan kadınlarda endometrial, servikal ve ovaryan malinite insidansı yok denecek kadar azdır. Düşük rüskli endometrial ve servikal prekanseröz lezyonların dahil edilmesi ile insidans artar. Bizim sonuçlarımız uterus koruyucu prolapsus cerrahisi isteyen benzer populasyona yansıtabilinmesi için önemli bilgiler sunar. Anahtar KelimelerHisterektomi; Histopatoloji; Prekanseröz; Prolapsus Abstract Aim: The aim of the study was is to assess the incidence of unexpected gynecological cancers and pre-cancerous lesions following hysterectomy for pelvic organ prolapse to better understand the risks of uterine sparing surgery. Material and Method: This was a retrospective analysis of histopathology findings after hysterectomy for uterine prolapse surgery who underwent preoperative diagnostic work including cervical cytology, transvaginal ultrasonography and endometrial histopathological examination for a high risk group (Postmenopausal women with an endometrial thickness of ≥5 mm and premenopausal women with abnormal bleeding). Patients with a history of endometrial, cervical and/or adnexal precancerous or cancerous pathological conditions and with incomplete medical records were excluded.Results: Results were taken from 106 women who underwent hysterectomy. The abdominal route was used in 22 cases (21.7 %), the vaginal route in 82 patients (77.4 %) and laparoscopic-assisted vaginal route in two (1.9 %) women. Oophorectomy was performed in 35 (33 %) cases. None of the patients had malignant histopathology specimens from hysterectomy. Total premalignant pathology incidence was 7.5 % (8/106). S...

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Section: Discussionsupporting

confidence: 80%

The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse

Aydın¹

2016

Ann Clin Anal Med

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“…The precolpocleisis exam should include a careful speculum exam with visual inspection of the cervix and vagina followed by palpation of the entire vagina [ 8 ] as well as a bimanual and rectal exam in addition to cervical cytology, transvaginal ultrasound, and endometrial sampling when indicated [ 11 ]. The role of transvaginal ultrasound as a preoperative tool in the assessment of gynecologic pathology has been suggested by several authors [ 11 , 12 ]. There is a 1.1% risk of missing an early endometrial carcinoma in postmenopausal women when preserving the uterus for prolapse surgery and thus a preoperative ultrasound is recommended in all cases followed by endometrial sampling when indicated [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Gynecologic Malignancies Post-LeFort Colpocleisis

Elkattah

Brooks

Huffaker

2014

Case Reports in Obstetrics and Gynecology

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Introduction. LeFort colpocleisis (LFC) is a safe and effective obliterative surgical option for older women with advanced pelvic organ prolapse who no longer desire coital activity. A major disadvantage is the limited ability to evaluate for post-LFC gynecologic malignancies. Methods. We present the first case of endometrioid ovarian cancer diagnosed after LFC and review all reported gynecologic malignancies post-LFC in the English medical literature. Results. This is the second reported ovarian cancer post-LFC and the first of the endometrioid subtype. A total of nine other gynecologic malignancies post-LFC have been reported in the English medical literature. Conclusions. Gynecologic malignancies post-LFC are rare. We propose a simple 3-step strategy in evaluating post-LFC malignancies.

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“…18 Another study of 49 women correlated the size of the nongravid uterus measured by ultrasound with bimanual examination before hysterectomy and postoperative surgical pathology specimens. 18 Another study of 49 women correlated the size of the nongravid uterus measured by ultrasound with bimanual examination before hysterectomy and postoperative surgical pathology specimens.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Vaginal Hysterectomy for Benign Disease Without Prolapse

Kulkarni

Rogers

2010

Clinical Obstetrics &Amp; Gynecology

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Vaginal hysterectomy was the first minimally invasive surgical approach for benign gynecologic conditions. Recently a number of other approaches for hysterectomy have been introduced, yet when compared with vaginal hysterectomy these approaches do not offer significant benefit for similar indications. The focus of this chapter is to provide comprehensive review of vaginal hysterectomy for the practicing clinician.

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Is transvaginal ultrasound a worthwhile investigation for women undergoing vaginal hysterectomy?

Cited by 8 publications

References 13 publications

The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse

The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse

Gynecologic Malignancies Post-LeFort Colpocleisis

Vaginal Hysterectomy for Benign Disease Without Prolapse

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