Hysterectomy in women with cervical stenosis. Surgical indications and pathology.
OBJECTIVE
To evaluate indications for surgery and final pathology results in patients who underwent hysterectomy with a concurrent diagnosis of cervical stenosis.


METHODS
Retrospective chart review of 25 women who underwent hysterectomy after diagnosis of cervical stenosis.


RESULTS
The average age was 59 years (range, 38-80). Indications for surgery included postmenopausal bleeding in 10 patients, previous dysplasia with inadequate Papanicolaou test follow-up in 4, recurrent high grade squamous intraepithelial lesion in 1, chronic pelvic pain in 5, acute pain in 2, dysfunctional uterine bleeding in 2 and thickened endometrial stripe in 1 patient on tamoxifen. An attempt to obtain an endometrial sample was unsuccessful in 14 patients. Twenty patients had undergone prior gynecologic surgery. The results of final cervical pathologic examination revealed severe cervical dysplasia or carcinoma in situ in 3. Final uterine pathology revealed 1 patient with uterine adenocarcinoma and 19 patients with benign pathology, including endometritis, fibroids, adenomyosis and endometrial hyperplasia.


CONCLUSIONS
The majority of patients with cervical stenosis resulting in inadequate cancer screening and/or symptoms resulting from stenosis will have significant benign pathology (64%), cervical dysplasia (12%) or uterine cancer (4%). For these patients, hysterectomy is a reasonable option.
Newman
Chevies
C
Department of Obstetrics and Gynecology, Ochsner Clinic, Alton Ochsner Medical Foundation, New Orleans, Louisiana, USA.
Finan
Michael A
MA
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D019092:Conization; D003251:Constriction, Pathologic / Q000150:complications / Q000473:pathology / Q000601:surgery; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D065006:Papanicolaou Test; D017699:Pelvic Pain; D017698:Postmenopause; D002577:Uterine Cervical Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology; D014591:Uterine Diseases / Q000453:epidemiology / Q000473:pathology; D014592:Uterine Hemorrhage; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears