Histopathological Profile of Abnormal Uterine Bleeding- A Two-Year Singleinstitutional Study

Abstract

BACKGROUND Abnormal uterine bleeding is the leading cause for the Gynaecologist's referral and it accounts for two-thirds of all Hysterectomies. Various causes including structural and non-structural can result in abnormal uterine bleeding. Abnormal uterine bleeding can result in significant morbidity and can interfere with personal and social well-being. The aim of this study is to evaluate the structural and non-structural causes associated with abnormal uterine bleeding and to study the endometrial patterns among hysterectomy specimens without structural abnormality. MATERIALS AND METHODS Hysterectomy specimens of all the patients who presented with complaints of Abnormal Uterine Bleeding were selected and detailed histopathological analysis done. Findings were correlated with clinical symptoms and available investigations. Pregnancy related complications and cases of cervical carcinomas were not included in the study. Statistical Analysis Used-The data obtained were analysed using SPSS Software Version 17. Settings and Design-This is a hospital-based descriptive study on 408 hysterectomy specimens conducted at Shanmugha Hospitals and Salem Cancer Institute, Salem, Tamilnadu. RESULTS A total of 408 hysterectomy specimens were included in the study. Age group of the patients included in the study ranged from 20 to 80 years with 245 (60.04%) patients between 41 and 50 years. Of 408 specimens, 276 (67.64%) had structural abnormality. Majority in the study group had Leiomyoma, which accounted for 164 (40.19%) cases followed by abnormal uterine bleeding with endometrium in proliferative phase accounting for 84 (20.58%) cases. Remaining histopathological profiles included 24 (5.88%) secretory endometrium, 10 (2.45%) endometrial atrophy, 05 (1.22%) disordered proliferative endometrium, 57 (13.97%) adenomyosis, 35 (8.57%) endometrial polyp, 7 (1.71%) endometrial hyperplasia, 3 (0.7%) endocervical polyp, 2 (0.49%) granulomatous endometritis and 17 (4.16%) endometrial carcinomas. CONCLUSION Various structural and non-structural causes are associated with abnormal uterine bleeding. Most common cause associated with abnormal uterine bleeding in our study and institution is Leiomyoma which constitutes for 40.19% with least being Granulomatous Endometritis (0.49%).