The Pathologic Spectrum of Prolapsus Uteri: Histopathologic Evaluation of Hysterectomy Specimens

Uterine prolapsus constitutes a major indication for hysterectomy in clinical practice. In this study, we evaluated the incidental histopathologic findings in hysterectomy specimens removed for uterine prolapsus. All patients treated with hysterectomy—with or without salpingo- oophorectomy—between 1997 and 2004 for the diagnosis of uterine prolapse were retrieved from the histopathology files. There were 68 cases available. The mean age of the patients was 59.5 years (range, 38–77 years), and 69.1% were over 50 years of age. Incidental findings were identified in 36 of 68 cases (52.94%). Microscopic abnormalities of no clinical relevance in uterus included leiomyoma (20 cases), adenomyosis (14 cases), endometrial polyp (three cases), and one case of endometritis. Cases with significant microscopic findings were identified as five cases of simple hyperplasia and one case of endometrioid adenocarcinoma. Additionally, a case with a focal CIN 2 was identified in the cervix. We strongly encourage a microscopic evaluation of all the normal-looking hysterectomy specimens, as the occasional presence of malignant tumors—either in the endometrium or the cervix—can only be accurately diagnosed by microscopic examination. (J GYNECOL SURG 21:133)