Necessity of endometrial biopsy in women with enlarged uteri and a preoperative diagnosis of uterine leiomyomata.
OBJECTIVE
To determine the necessity of a preoperative endometrial biopsy when evaluating a patient with symptomatic uterine fibroids.


METHODS
This was a retrospective study of 182 cases of hysterectomy for symptomatic uterine fibroids. The patients were stratified into 2 groups: those with uteri weighing between 280 and 500 g and with uteri weighing > 500 g. Charts were reviewed for all patients who did not have an endometrial biopsy and for all cases of malignancy.


RESULTS
Of the patients with menorrhagia, 21-30% did not undergo a preoperative biopsy. In those who did, biopsy failed to detect 2.75% of malignancies. All patients diagnosed postoperatively with malignancy had presented with complaints of bleeding.


CONCLUSIONS
With complaints other than bleeding, a preoperative endometrial biopsy may be omitted. However, any menstrual complaints warrant an investigation of the endometrium even though the incidence of endometrial carcinoma in these larger uteri is only 1.1%.
Duplantier
Noel
N
Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, Department of Electrical Engineering, University of New Orleans, New Orleans, Louisiana, USA.
Finan
Michael A
MA
Barbe
Trudy
T
D000368:Aged; D001707:Biopsy, Needle; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009929:Organ Size; D017699:Pelvic Pain / Q000503:physiopathology; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000503:physiopathology; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery*