EC Gynaecology

Objective: To determine the prevalence of preoperatively undiagnosed cervical intraepithelial neoplasia (CIN) in hysterectomy specimens and to assess the implications for clinical practice.

Methods: A retrospective descriptive study was conducted at a teaching hospital in Colombo, Sri Lanka, involving 240 consecutive patients aged 35 - 65 years who underwent hysterectomy between 2019 and 2022. Patients with known cervical abnormalities, macroscopic cervical lesions, subtotal hysterectomy, or cervical carcinoma were excluded. Demographic and gynecological data were extracted from medical records, and histopathological reports were reviewed to identify the presence of CIN. Descriptive statistics were used to summarize the data, and the prevalence of CIN was calculated as a percentage of total hysterectomy specimens.

Results: Among the 240 patients, 2 (0.83%) had CIN identified in the hysterectomy specimens, both of which were preoperatively undiagnosed. The most common histopathological diagnoses were leiomyoma (78 cases), adenomyosis (42 cases), and endometrial hyperplasia (6 cases).

Conclusion: The prevalence of preoperatively undiagnosed CIN in hysterectomy specimens is low but non-negligible. This underscores the importance of comprehensive preoperative screening, including thorough cervical evaluation, even in patients undergoing hysterectomy for non-cervical indications.

 Keywords: Cervical Intraepithelial Neoplasia; Hysterectomy; Preoperative Screening; Histopathology; Cervical Cancer

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