Gynecological Pathology in Women Experiencing Hysterectomy for Utero-Vaginal Prolapse.

Abstract

Objectives: To determine the gynecological pathology on histopathology in women undergoing vaginal hysterectomy for utero-vaginal prolapse at Tertiary Care facility. Methods: This cross-sectional study was conducted, in Department of Obstetrics & Gynecology PUMHS Nawabshah (SBA) froin August 2015 to July 2017. 150 patients admitted with diagnosis of pelvic organ prolapse (POP). 120 patients under gone elective hysterectomies, rest are not included in study (either managed conservatively or fit in exclusion criteria). Patients under gone through pre-operative preparation including papsmear, high vaginal swab, pelvic scan, and informed consent taken. Patients diagnosed with pre malignant and malignant condition and women with abnormal uterine bleeding were excluded from this study. Surgically removed specimen sent for histopathological assessment. Reports collected, data. entered. tabulated then statistically analyzed. Result: 120 hysterectomies were done for indication of POP. 107 (89.2('/o) were operated via vaginal route and 13(10.8%) though abdominal. Mean age with SD 53.28 +725 years, ranging from 37 to 67 years. One was nulliparous (0.%) rest multipara (99.2°,0. Over all 3.33% cases found to have pre malignant pathology. Histological assessment shows atrophic endometrium in 43.3%, secretory in 7.5%, proliferative in 5%, hyperplasia of any type in 1.7°.'0, endometritis in 42.5%, while no case of endometrial cancer found. Myometriurn was unremarkable in 109 patients, focal adenomyosis in 10 and leiomyoma in 1 patient, Cervical tissue analysis show evidence of infection in 104 patient, CIN 1 in 1 and CIN 3 in 1 patients and insignificant in rest. One patient had simple ovarian cyst. Conclusion: Remote consequences of pelvic organ prolapse and because of co-incidental risk of malignancy, the specimen even after reconstructive surgery should be sent for histological analysis, owing to high false negativity of screening test.