Title: Clinico-Pathological Correlation of Hysterectomy Specimens for Abnormal Uterine Bleeding in Peri Menopausal Women
Author: Dr Sujeet Kumar Mandal, MD Pathology
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.125
Abstract
Background: Abnormal Uterine Bleeding (AUB) - a term used to describe any type of bleeding that does not fall within the normal ranges for amount, frequency, duration, or cyclicity. The most common presentations are menorrhagia, polymenorrhoea, metrorrhagia, and intermenstrual bleeding. AUB during premenopausal period poses a diagnostic challenge to clinician and pathologist, as early diagnosis and treatment depends on that.
Aims and Objectives: To Correlate clinical and histopathological pattern in women with peri menopausal bleeding by studying hysterectomy specimens.
Material and Methods: After obtaining institutional Ethical Committee approval and written informed consent, hysterectomy specimens of 200 patients with abnormal uterine bleeding were studied for histopathological examination during the period of December 2014to December 2016.
Results: Mean age of cases was 41.2 ±6.8 years. Majority of the cases of peri menopausal uterine bleeding was in age group of 45 – 55 years (61 %). Disuterine bleeding, Fibroid, DUB with PID was commonest indications for which hysterectomy was indicated. Non Descent Vaginal Hysterectomy was commonest hysterectomy procedure performed (64 %). The most common histopathological finding was leimyoma found in 36.5 % of cases, followed by adenomyosis which was found in 13.5 % cases.
Conclusion: Leiomyoma are the most common benign conditions found in hysterectomy specimens with peak incidence at 45-55 years. Histopathology is mandatory for confirming diagnosis and ensuring optimal management.
References
1. Aravindpallipady,Sandyaillanthody et al. A clinic-morphological spectrum of the non-neoplastic lesions of the Uterine cervix at AJ Hospital,Mangolore;Journal of clinical and diagnostic research. 2011June,vol-5(3):546-550.
2. Aytekin Tokmak,Ali Irfan Guzel et al.Clinical significance of Atypical squa-mous cells of undetermined significance in detecting Preinvsive cervical lesions in post-menopausal Turkish women, Asian pacific Journal of cancer prevention,vol 15,2014,6639-6641.
3. Veena S Naik,Jyoti D Rege et al;Pathology of genital tract in post-menopausal bleeding,dept of pathology. T.N.Medical college and BYL nairch. hospital, Mumbai, Bombay hospital Journal,1996.
4. Côté I, Jacobs P, Cumming DC. Use of health services associated with increased menstrual loss in the United States. Am J Obstet Gynecol. 2003;188:343–8.
5. Dr.BangalVB,Patil NA et al,Colposcopy guided management of cervical erosions in Rural population,Scholars journal of Applied medical sciences.,2014;IC:261-265.
6. Ali Hassan Al-Timim,NadiaMudher Al-Hilli et al,Post-menopausal bleeding: Clinicopathological study in Babel province between the years 2000-2009
7. Rimsza ME. Dysfunctional uterine bleeding. Pediatr Rev. 2002;23:227–33.
8. Yogesh Neena, Bhaskar Honey, “Clinico-pathological correlation of hysterectomy specimens for abnormal uterine bleeding in rural area”. Journal of Evolution of Medical and Dental Sciences 2013; Vol2, Issue 39, September 30; Page: 7506-7512.
9. Talukdar B, Mahela S. Abnormal uterine bleeding in perimenopausal women: Correlation with sonographic findings and histopathological examination of hysterectomy specimens. Journal of Mid-Life Health. 2016;7(2):73-77
10. Sarfraz TS, Tariq H. Histopathologic findings in menorrhagia a study of 100 hysterectomy specimens. Pak J Pathol. 2005;16:83–5
11. Khreisat B, Al-Rawabdeh S, Duqoum W, Al Qudah M. Adenomyosis: Frequency of hysterectomy in histopathological specimens at two Jordanian military hospitals. JRMS. 2011;18:76–9.)
12. Sajjad M, Iltaf S, Qayyum S. Pathological findings in hysterectomy specimens of patients presenting with menorrhagia in different age groups. Ann Pak Inst Med Sci. 2011;7:160–2.
13. Gupta A, Rathore AM, Manaktala U, Rudingwa P. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. IJBAR. 2013;04:509–13.)
14. Shergill SK, Shergill HK, Gupta M, Kaur S. Clinicopathological study of hystere-ctomies. J Indian Med Assoc. 2002; 100:238–9, 246.
15. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–7.
16. Adelusola KA, Ogunniyi SO. Hysterec-tomies in Nigerians: Histopathological analysis of cases seen in Ile-Ife. Niger Postgrad Med J. 2001;8:37–40.