Diagnostic Strategies for Postmenopausal Bleeding

Breijer, Maria; Timmermans, Anne; Doorn, Helena C. van; Mol, Ben Willem J.; Opmeer, Brent C.

doi:10.1155/2010/850812

Cited by 52 publications

(45 citation statements)

References 37 publications

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“…In future the research should be focused to achieving a higher accuracy of different diagnostic strategies. 5,4 In our study transvaginal sonography showed same results as in Histopathology findings revealed was Atrophic uterus in 64 (57.14%) patients, endometrial polyp in 7 (6.25%), Endometrial hyperplasia in 24 (21.4%), Endometrial carcinoma in 8 (7.14%), Pyometra in 5 (4.46%) and Fibroid uterus in 4 (3.5%) patients. Compare the study of 4 reported the histopathological results in postmenopausal bleeding patients were atrophic endometrium in 72 (58.5%), endometrial polyp in 37 (30%) cases, Endometrial hyperplasia in 9 (7.3%) cases and adenocarcinoma in 1 (0.8%) cases.…”

supporting

confidence: 82%

POSTMENOPAUSAL UTERINE BLEEDING; CORRELATION OF THE FINDINGS OF TRANSVAGINAL ULTRASONOGRAPHY & ENDOMETRIAL SAMPLING IN PATIENT

Memon

Munwar²,

Bilquees³

et al. 2016

TPMJ

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ABSTRACT… Objectives: To find out the significance of the transvaginal sonography (TVS) in postmenopausal women (PMW) with postmenopausal bleeding (PMB) and compare it with the histopathological diagnosis at curettage, so that unnecessary operations could be avoided. Study Design: Descriptive study. Setting: Radiological Department for TVS and H/P at the Department of Gynecology & Obstetrics (Gynae: Unit IV) at Liaquat University Medical, Health Sciences Hospital Jamshoro and Hyderabad. Period: September 2010 to September 2011. Material and Methods: The present study was conducted on patients with postmenopausal bleeding. Results: The mean age + SD of the women was 51 + 3.1 years, ranging from a minimum of 49 to 55 years. The mean endometrial thickness was from 1.8-15mm. Transvaginal Sonography and Histopathological Findings: Histopathological findings revealed endometrial atrophy in 64 (57.14%) patients, Endometrial hyperplasia in 24(21.4%), endometrial polyp in 7(6.25%), Endometrial carcinoma in 8 (7.14%), Pyometra in 5(4.46%) and Fibroid uterus in 4(3.57%). With a cut off value of 4mm endometrial thickness, TVS showed a sensitivity of 100%, specificity of 73.33%, a positive predictive value of 76.47%, a negative predictive value 100% and an accuracy of 85.71%. At a cut off limit of 5mm endometrial thickness (endometrium >5mm indicating pathology), the sensitivity of the present study was 92.3% and the specificity was 86.6 %. The positive predictive value was 85.71%, the negative predictive value was 92.86 % and the accuracy was 89 %. Conclusion: TVS is a useful tool to triage post menopausal women with bleeding and avoid un convenient invasive procedure.

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supporting

confidence: 82%

POSTMENOPAUSAL UTERINE BLEEDING; CORRELATION OF THE FINDINGS OF TRANSVAGINAL ULTRASONOGRAPHY & ENDOMETRIAL SAMPLING IN PATIENT

Memon

Munwar²,

Bilquees³

et al. 2016

TPMJ

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“…The peak incidence of malignancy was observed in the age group of 55-64 years. 13 Post menopausal bleeding has been evaluated by clinical examination, pelvic ultrasound, investigations like pap smear & fractional curettage in this study.…”

Section: Discussionmentioning

confidence: 99%

Postmenopausal bleeding: clinicopathologic study in a teaching hospital of Andhra Pradesh

Kothapally

Bhashyakarla

2013

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONWHO defines menopause as permanent cessation of menstruation resulting from loss of ovarian activity. 1 Postmenopausal bleeding (PMB) is defined as abnormal uterine bleeding occurring after 1 year of menopause. Common menopausal age in Indians is 45-50 years. Postmenopausal women constitute only 1% of female population. Postmenopausal bleeding represents one of the most common reasons for referral to gynaecological services, largely due to suspicion of an underlying endometrial malignancy.2 A woman not taking hormone replacement therapy (HRT) who bleeds after the menopause has a 10% risk of having genital cancer and a further 10% risk of significant pathology.3 Therefore, postmenopausal bleeding should always be investigated no matter how minimal or non-persistent.Etiology of post-menopausal bleeding include: nongynaecological causes like trauma or a bleeding disorder, use of hormone replacement therapy, vaginal atrophy, endometrial hyperplasia (simple, complex, and atypical), endometrial carcinoma usually presents as PMB but 25% occur in premenopausal women. Other causes include endometrial polyps or cervical polyps, carcinoma of Results:The commonest finding of pelvic USG was increased endometrial thickness (>4mm) (80%). The histopathological analysis showed proliferate endometrium (36.3%), atrophic endometrium (16.6%), cystoglandular hyperplasia (10%) and endometrium hyperplasia (6.6%). Incidence of cervical and endometrial carcinomas was 10% and 6.6%, respectively. Conclusion: the postmenopausal bleeding is an important symptom and requires careful and timely assessment to eliminate the possibility of malignancy as soon as possible.

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“…Our study and other studies have found a maximum incidence of AUB in the perimenopausal age group (9,10). Perimenopause is defined by the as the 2-8 years preceding menopause and the 1 year after the final menses (11). As women approach menopause, cycles shorten and often become intermittently anovulatory due to a decline in the number of ovarian follicles and fluctuations in the estradiol level leading to various patterns of abnormal bleeding (12)Our study and other studies found menorrhagia as the most common complaint (13).…”

Section: Resultsmentioning

confidence: 57%

Histopathological Pattern of Endometrium in Abnormal Uterine Bleeding

2015

IJSR

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Abnormal uterine bleeding (AUB) is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. The aim of this study was to find the histopathological pattern of endometrium in abnormal uterine bleeding in all age groups.This is a prospective cohort study of 221 patients admitted over the period 2012 and May 2014 to the Obstetric Gynecologic University Hospital"Queen Geraldine", in Tirana, Albania.Cases of AUB with a probable endometrial cause were included in the study. The most common histological pattern of endometrium includes Secretory (29%) followed by Proliferative endometrium(25%), disordered proliferative (13%) and endometrial hyperplasia(7%).All patients having abnormal menstrual bleeding should be subjected to dilatation and curettage to rule out endometrial pathology.

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Diagnostic Strategies for Postmenopausal Bleeding

Cited by 52 publications

References 37 publications

POSTMENOPAUSAL UTERINE BLEEDING; CORRELATION OF THE FINDINGS OF TRANSVAGINAL ULTRASONOGRAPHY & ENDOMETRIAL SAMPLING IN PATIENT

POSTMENOPAUSAL UTERINE BLEEDING; CORRELATION OF THE FINDINGS OF TRANSVAGINAL ULTRASONOGRAPHY & ENDOMETRIAL SAMPLING IN PATIENT

Postmenopausal bleeding: clinicopathologic study in a teaching hospital of Andhra Pradesh

Histopathological Pattern of Endometrium in Abnormal Uterine Bleeding

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