Histopathology diagnosis in women who underwent a hysterectomy for a benign condition.

PURPOSE: To study the correlation between the preoperative clinical diagnosis and the final histopathology of hysterectomy specimens. METHODS: This is a retrospective study by the authors of all cases who underwent a hysterectomy over a 2- year period (2008-2009). All hysterectomies performed for malignant indication were excluded. RESULTS: During the 2- year study period there were a total of 137 cases eligible for analysis. 107 patients had hysterectomy alone and 30 patients had hysterectomy with salpingo-oophorectomy. The abdominal route was used in 122 cases (89%) and the vaginal one in 15 patients (11%). The mean age at the time of hysterectomy was 49.1 years (range 35-76 years). Heavy menstrual loss was the most common indication for hysterectomy accounting for 39% of the cases. The rest of the indications included, fibroids, abdominal pain, postmenopausal bleeding, uterine prolapse and others. The histopathology of the endometrium prior to hysterectomy was reported in 68% of the cases and the most common finding was an endometrium with signs of hormonal imbalance. In the final histopathology reports of the hysterectomy specimens, fibroid was the most common finding reported in 36.5% of the cases. Adenomyosis was reported in 28% of the cases, endometrial hyperplasia in 12%, no specific pathology in 10% and malignancy in 5%. CONCLUSIONS: Hysterectomy will remain a common gynecological operation in both developing and developed countries. The clinical and the pathological correlation are poor, when abdominal pain or dysfunctional uterine bleeding (DUB) was the preoperative clinical diagnosis. However, there was a very high correlation when the clinical diagnosis was a fibroid. All hysterectomy specimens should be sent for histopathology regardless of the preoperative histopathology of the endometrium.

Incidence of anti-zona pellucida and anti-sperm antibodies among infertile Jordanian women and its relation to mycoplasmas.

Anti-zona-pellucida autoantibodies (AZP-Ab) and anti-sperm isoantibodies (ASA) were assessed in the cervical secretions from 73 infertile Jordanian women and 41 fertile control women using latex agglutination. Significantly more women with infertility had AZP-Ab and ASA (16.4% and 8.2% respectively) compared with fertile women (9.4% and 0%), with no relation to the etiology of infertility. Using polymerase chain reaction Mycoplasma hominis and Ureaplasma urealyticum were detected in cervical secretions of 19.2% and 13.7% of infertile women, and the presence of mycoplasma was significantly correlated with the presence of AZP-Ab and ASA.

Incidence of anti-zona pellucida and anti-sperm antibodies among infertile Jordanian women and its relation to mycoplasmas

Anti-zona-pellucida autoantibodies [AZP-Ab] and anti-sperm isoantibodies [ASA] were assessed in the cervical secretions from 73 infertile Jordanian women and 41 fertile control women using latex agglutination. Significantly more women with infertility had AZP-Ab and ASA [16.4% and 8.2% respectively] compared with fertile women [9.4% and 0%], with no relation to the etiology of infertility. Using polymerase chain reaction Mycoplasma hominis and Ureaplasma urealyticum were detected in cervical secretions of 19.2% and 13.7% of infertile women, and the presence of mycoplasma was significantly correlated with the presence of AZP-Ab and ASA

Prevalence of Chlamydia trachomatis infection in infertile women at a university hospital in Jordan.

In a prospective controlled study, we aimed to determine the prevalence of Chlamydia trachomatis infection in Jordanian women attending an infertility clinic and whether screening is useful as part of routine investigations for infertility. Two groups of patients (152 infertile patients and 146 control patients) had endocervical swab testing by polymerase chain reaction for the presence of C. trachomatis infection. A total of 6/152 patients in the infertility group tested positive for C. trachomatis (3.9%), compared with 1/146 patients in the control group (0.7%), a difference that was not statistically significant. In view of the tendency toward increased prevalence of C. trachomatis infection, screening women for chlamydial infection as part of routine investigations for infertility is recommended.

Prevalence of Chlamydia trachomatis infection in infertile women at a university hospital in Jordan

In a prospective controlled study, we aimed to determine the prevalence of Chlamydia trachomatis infection in Jordanian women attending an infertility clinic and whether screening is useful as part of routine investigations for infertility. Two groups of patients [152 infertile patients and 146 control patients] had endocervical swab testing by polymerase chain reaction for the presence of C. trachomatis infection. A total of 6/152 patients in the infertility group tested positive for C. trachomatis [3.9%], compared with 1/146 patients in the control group [0.7%], a difference that was not statistically significant. In view of the tendency toward increased prevalence of C. trachomatis infection, screening women for chlamydial infection as part of routine investigations for infertility is recommended

Laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy in stage I endometrial cancer.

The purpose of this study was to evaluate and compare laparoscopic treatment for stage I endometrial cancer with the traditional transabdominal approach. From July 1996 to July 1998, 61 patients with clinical stage I endometrial cancer were treated at the Gynaecology Oncology Unit at the Royal North Shore of Sydney, Australia. Twenty-nine patients were treated with laparoscopic assisted vaginal hysterectomy (LAVH) and bilateral salpingo-oophrectomy (BSO) plus minus laparoscopic pelvic lymphadenectomy (LPLA), while 32 patients were treated with the traditional laparotomy and underwent total abdominal hysterectomy (TAH) and BSO plus minus pelvic lymphadenectomy (PLA). The main outcomes studied were operative time, blood loss, blood transfusion, intraoperative complications, postoperative complications, duration of hospital stay, and number of lymph nodes obtained. In conclusion, laparoscopic treatment of endometrial cancer is safe in the hands of experienced operators with minimal intraoperative and postoperative complications. This procedure is associated with significantly less blood loss and shorter hospitalization; however, it is associated with significantly longer operating time. Proper selection of patients for the laparoscopic procedure is the vital step in achieving the major goals of this approach.