Uterus conserving prolapse surgery-what is the chance of missing a malignancy?

Recently, there has been a move towards uterine preserving surgery in the management of pelvic organ prolapse. The negative implications of such surgery have not been delineated. This study aims to identify the risk of finding an unexpected malignancy in these cases. A database containing details of vaginal hysterectomies performed over a 10-year period was searched. Women who underwent surgery for uterine prolapse were included. Women with other indications for surgery and those who presented with symptoms relating to endometrial or cervical malignancy were excluded. As this is a non-interventional observational study, formal ethical approval was not obtained. Out of 517 women who underwent a vaginal hysterectomy for prolapse, four cases of endometrial carcinoma were identified giving an incidence of 0.8%. Conserving a prolapsed uterus without further investigations runs the risk of missing women with endometrial malignancy.