A study on the correlation of clinical and ultrasonography diagnosis with histopathological outcome in cases of hysterectomy

Debapriya Saha, Prince Parikh, Nimesh B. Thakkar
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2020 · vol. 9(7) , pp. 2921 · doi:10.18203/2320-1770.ijrcog20202734 · W3037195281
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study compared preoperative clinical and ultrasound diagnoses with histopathology in 100 hysterectomy cases, finding high correlations for fibroid uterus and adenomyosis but poor correlation for dysfunctional uterine bleeding, and noted one missed malignancy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-15 · read from full text ⓘ

This study evaluated the correspondence between preoperative clinical and ultrasonography diagnoses and the histopathology (HPE) results of hysterectomy specimens in 100 cases of benign gynecological disorders; malignant cases were excluded. The most common preoperative diagnosis was fibroid uterus (39%), with 94.87% showing positive correlation with HPE, while adenomyosis showed a 100% correlation between preoperative diagnosis and HPE outcome; however, the correlation for dysfunctional uterine bleeding (DUB) was poor, with 57.14% of clinically diagnosed DUB cases showing adenomyosis on HPE. A major limitation explicitly noted was that one case of endometrial adenocarcinoma was missed on clinical evaluation, despite exclusion of malignancy from the study. This paper is centrally about endometriosis and/or adenomyosis—specifically adenomyosis—because it reports the diagnostic correlation between clinical/ultrasound findings and histopathology for adenomyosis in hysterectomy cases.

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Abstract

Background: Hysterectomy is the most commonly performed gynaecological operation throughout the world due to different causes of pelvic pathology. Fewer studies have been performed describing the relationship between preoperative clinical, ultrasonological diagnosis and histopathological outcome.Methods: Authors report 100 cases with benign gynecological disorders who underwent hysterectomy. Authors excluded malignant cases from the study. A preoperative diagnosis was formed based on clinical and ultrasound examination and it was compared with the histopathological report of the hysterectomy specimen.Results: In this study the most common preoperative diagnosis for hysterectomy was fibroid uterus (39%) among which 94.87% showed positive correlation with HPE. Correlation for adenomyosis was 100% between preoperative diagnosis and HPE outcome. Correlation for DUB was poor. 57.14% of the preoperatively diagnosed DUB cases showed adenomyosis on HPE. One case of fibroid showed adenocarcinoma of endometrium on HPE.Conclusions: The study fulfills the aim of finding the efficacy of clinical and USG findings in diagnosing gynecological disorders accurately. Clinical examination is not always adequate. USG is the most important, simple and easily accessible investigation. There is one missed malignant case in this study which is a major shortcoming of clinical evaluation.
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Background

Hysterectomy is the most commonly performed gynaecological operation throughout the world due to different causes of pelvic pathology. Fewer studies have been performed describing the relationship between preoperative clinical, ultrasonological diagnosis and histopathological outcome.

Methods

Authors report 100 cases with benign gynecological disorders who underwent hysterectomy. Authors excluded malignant cases from the study. A preoperative diagnosis was formed based on clinical and ultrasound examination and it was compared with the histopathological report of the hysterectomy specimen.

Results

In this study the most common preoperative diagnosis for hysterectomy was fibroid uterus (39%) among which 94.87% showed positive correlation with HPE. Correlation for adenomyosis was 100% between preoperative diagnosis and HPE outcome. Correlation for DUB was poor. 57.14% of the preoperatively diagnosed DUB cases showed adenomyosis on HPE. One case of fibroid showed adenocarcinoma of endometrium on HPE.

Conclusions

The study fulfills the aim of finding the efficacy of clinical and USG findings in diagnosing gynecological disorders accurately. Clinical examination is not always adequate. USG is the most important, simple and easily accessible investigation. There is one missed malignant case in this study which is a major shortcoming of clinical evaluation. Metrics

References

Vessey MP, Villard‐Mackintosh LA, Mcpherson K, Coulter A, Yeates D. The epidemiology of hysterectomy: findings in a large cohort study. Int J Obstet Gynaecol. 1992;99(5):402-7. John A, Rock MD, Jhon D, Thompson MD. Telinds’s operative gynaecology. 1st Edition Lippincott. Med J. 2003:878-890. Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007;110(5):1091-5. Prusty RK, Choithani C, Gupta SD. Predictors of hysterectomy among married women 15-49 years in India. Reprod Health. 2018;15(1):3. Gor HB. Hysterectomy: Background, History of the procedure, problem; 2018, Available at: https://emedicine.medscape.com/article/267273-overview. Accessed on 20th February 2020. Save the uterus seminar, 2014. Find it on indianewsreel.com Available at: http://www.indianewsreel.com/Health/Events/20141523091527/Save-the-uterus-seminar.aspx. Accessed on 20th February 2020. Sobande AA, Eskander M, Archibong EI, Damole IO. Elective hysterectomy: a clinicopathogical review from Abha catchment area of Saudi Arabia. West African J Med. 2005;24(1):31-5. Subrata P, Srabani C, Anuradha S, Prakash PJ, Kingshuk B, Mrinal S. A retrospective clinico-pathological study of hysterectomy cases in a tertiary care hospital in India-a review of 950 cases. Bangladesh J Med Sci. 2018;17(1):88-92. Kumari A, Biswas PK. Clinical and USG diagnosis versus histopathological outcome in cases of hysterectomy. Sch J App Med Sci. 2017;5(10D):4080-7. Alakananda, Das KK, Muralidhara. A study on correlation of clinical and ultrasound diagnosis with histopathology in cases of hysterectomy done for benign indications. Int J Sci Res. 2017;6(11):755-8. Rabiu A, Habib R. Elective abdominal hysterectomy: appraisal of indications and complications at Aminu Kano Teaching Hospital: an 8 year review. Trop J Obstet Gynaecol. 2017;34(3):224-8. Karthikeyan TM, Veenaa NN, Ajeeth Kumar CR, Thomas E. Clinicopathological study of hysterectomy among rural patients in a tertiary care center. J Dent Med Sci. 2015;14(5):25-7.

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