Necessity of endometrial biopsy in women with enlarged uteri and a preoperative diagnosis of uterine leiomyomata

J Reprod Med. 2003 Jan;48(1):23-7.


Objective: To determine the necessity of a preoperative endometrial biopsy when evaluating a patient with symptomatic uterine fibroids.

Study design: This was a retrospective study of 182 cases of hysterectomy for symptomatic uterine fibroids. The patients were stratified into 2 groups: those with uteri weighing between 280 and 500 g and with uteri weighing > 500 g. Charts were reviewed for all patients who did not have an endometrial biopsy and for all cases of malignancy.

Results: Of the patients with menorrhagia, 21-30% did not undergo a preoperative biopsy. In those who did, biopsy failed to detect 2.75% of malignancies. All patients diagnosed postoperatively with malignancy had presented with complaints of bleeding.

Conclusion: With complaints other than bleeding, a preoperative endometrial biopsy may be omitted. However, any menstrual complaints warrant an investigation of the endometrium even though the incidence of endometrial carcinoma in these larger uteri is only 1.1%.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biopsy, Needle*
  • Endometrium / pathology*
  • Female
  • Humans
  • Hysterectomy / methods
  • Leiomyoma / pathology*
  • Leiomyoma / surgery*
  • Middle Aged
  • Organ Size
  • Pelvic Pain / physiopathology
  • Preoperative Care
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Treatment Outcome
  • Uterine Hemorrhage / physiopathology
  • Uterine Neoplasms / pathology*
  • Uterine Neoplasms / surgery*