title: Bariatric surgery and endometrial pathology in asymptomatic morbidly obese women: a prospective, pilot study.
abstract: OBJECTIVE
  To determine the prevalence of occult uterine pathology in asymptomatic, morbidly obese women before and after bariatric surgery-induced weight loss.
  
  
  METHODS
  Prospective, blinded, non-interventional cohort.
  
  
  METHODS
  Urban teaching hospital.
  
  
  METHODS
  Morbidly obese women.
  
  
  METHODS
  Endometrial biopsies were obtained at the time of Roux-en-Y gastric bypass and again 1 year later. Both the patient and the physician were blinded to the results of the initial biopsy until the conclusion of the study. Specimens were independently reviewed by two blinded pathologists.
  
  
  METHODS
  Effect of bariatric surgery-induced weight loss on the prevalence of endometrial pathology at 1 year.
  
  
  RESULTS
  Fifty-nine women underwent an endometrial biopsy during bariatric surgery. The mean (range) age, weight, and body mass index (BMI) were 42 years (22-62 years), 127 kg (87-176 kg), and 46.8 kg/m(2) (36-64.3 kg/m(2) ), respectively. Four women had hyperplasia (three simple and one complex), for an overall prevalence of 6.8%. The prevalence among women not receiving some anti-estrogen therapy was 9.5%. Forty-six women (78%) underwent follow-up biopsy after a mean (range) weight loss of 42 kg (19-67 kg). Simple hyperplasia was identified in 3/46 women at the 1-year follow-up (6.5%). Two women had resolution of hyperplasia, two women had persistent, simple hyperplasia, and one had had a normal initial biopsy. No woman showed progressive pathology or cancer. At the end of the follow-up all but one patient had a documented resolution of endometrial pathology.
  
  
  CONCLUSIONS
  Asymptomatic morbidly obese women are at relatively high risk of harbouring occult endometrial hyperplasia. Bariatric surgery-associated weight loss reduced but did not eliminate this risk for endometrial pathology.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA. argenta@umn.edu
authors.forename: P A
authors.initials: PA
authors.lastname: Argenta
authors.forename: M
authors.initials: M
authors.lastname: Kassing
authors.forename: A M
authors.initials: AM
authors.lastname: Truskinovsky
authors.forename: C A
authors.initials: CA
authors.lastname: Svendsen
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology; D001706:Biopsy; D004714:Endometrial Hyperplasia / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D010865:Pilot Projects; D015995:Prevalence; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D015431:Weight Loss