title: Utility of preoperative endometrial assessment in asymptomatic women undergoing hysterectomy for pelvic floor dysfunction.
abstract: OBJECTIVE
  Uterine morcellation during laparoscopy for pelvic floor repair has prompted adoption of uterine screening tests by some surgeons. We report a case series of uterine malignancy incidentally diagnosed at the time of pelvic floor surgery.
  
  
  METHODS
  We reviewed records from patients undergoing hysterectomy for pelvic organ prolapse (POP) and/or urinary incontinence (UI) from January 2004 to December 2009 and abstracted preoperative screening trends and final pathologic diagnoses.
  
  
  RESULTS
  Of the 708 women in the study, 125 (18%) had preoperative endometrial biopsy (EB), 43 (6%) had pelvic ultrasound (US), and 21 (3%) had EB and US. Surgical route included vaginal (58%), abdominal (23%), and laparoscopic (18%). Most (97.1%) final pathologic diagnoses were benign. Five cancers (0.6%) were detected; four of these women had normal preoperative screening, including EB (2), US (1), or both tests (1).
  
  
  CONCLUSIONS
  Screening with EB + US was found to be ineffective in our cohort of patients due to the low prevalence of undetected uterine cancer in asymptomatic women planning POP/UI surgery.
authors.affiliation: Division of Female Pelvic Medicine & Reconstructive Surgery, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA. olgaramm@gmail.com
authors.forename: Olga
authors.initials: O
authors.lastname: Ramm
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Gleason
authors.forename: Saya
authors.initials: S
authors.lastname: Segal
authors.forename: Danielle D
authors.initials: DD
authors.lastname: Antosh
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Kenton
mesh_terms: D001706:Biopsy; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D033162:Incidental Findings; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D017773:Pelvic Floor / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D057234:Preoperative Period; D012189:Retrospective Studies; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery