Is it necessary to perform an endometrial sampling prior to hysterectomies for benign conditions?

Abstract

Aim: Hysterectomy is one of the most prevalent surgical intervention in gynecological field. This study concerns the requirement and necessity of an endometrial sampling to exclude an unpredictable uterine malignancy risk before hysterectomy for benign conditions. 

Methods: This is a retrospective and cross-sectional study involving 307 patients who had hysterectomy for benign conditions between years 2014-2018. Prior to hysterectomy, in 162 cases, an endometrial sampling was performed ahead (biopsy group) and in 145 cases, hysterectomy was performed without obtaining an endometrial sampling earlier on (control group). Pre- and post-surgical pathological evaluation reports were collected and compared between the groups.

Results: Features of the patients as mean age, number of previous pregnancies, being at postmenopausal status did not vary significantly between two groups. In the biopsy group, 51.2% of the patients were in the premenopausal period, 40.7% of the patients had postmenopausal bleeding and 52.5% had abnormal uterine bleeding symptoms and these three features were significantly higher than in the control group. In the control group, one case (0.7%) had leiomyosarcoma and another case (0.7%) had endometrial adenocarcinoma. In the biopsy group, endometrial adenocarcinoma was detected in 5 patients (3.1%) as significantly higher than in the control group.

Conclusion: If there are no symptoms, clinical and radiological findings suggesting an endometrial malignancy in patients who planned to undergo a hysterectomy for benign conditions, it is unnecessary to perform a routine endometrial biopsy.