The frequency of structural causes (PALM) according to FIGO PALM-COEIN classification in patients undergoing hysterectomy for abnormal uterine bleeding

Enes Akdan, Neşe Yücel, Fikriye Işıl Adıgüzel
In: Journal of Medicine and Palliative Care · 2025 · vol. 6(3) , pp. 289 · doi:10.47582/jompac.1722247 · W7163668572
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study retrospectively classified 847 women undergoing hysterectomy for abnormal uterine bleeding according to the FIGO PALM-COEIN system, finding leiomyoma to be the most frequent structural cause.

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This paper reports the frequency of structural causes of abnormal uterine bleeding categorized using the FIGO PALM-COEIN system in patients undergoing hysterectomy. The study population comprised individuals who received hysterectomy for abnormal uterine bleeding, and the authors used FIGO PALM-COEIN classification to estimate how often structural etiologies were present. The key finding is the distribution (frequency) of structural causes (PALM components) within this surgical cohort, as framed by the classification system. The paper is presented here as an erratum notice rather than providing full methodological or results detail in the provided text. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Aims: We aimed to determine the frequency of the PALM group in the FIGO PALM-COEIN system of patients who were operated for AUB, and to evaluate and analyze our data in our clinic.Methods: In a retrospective study, data were obtained for nonpregnant women aged 18–55 years who underwent hysterectomy for AUB at a center in Turkey in 2017-2022. The patients were retrospectively classified according to the PALM-COEIN system.Results: A total of 847 women were included. Leiomyoma was the most common pathology result in only 377 (44.5%) patients. The second most common pathology result was adenomyosis and leiomyoma coexistence in 132 (15.6%) patients. The third most common pathology result was 62 (7.3%) adenomyosis.Conclusion: In addition to the combined use of FİGO AUB system 1 and 2 in AUB, the notation grouping may be useful for clinicians in the management of AUB.
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References

- Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-194. doi: 10.1111/j.1524-4733. 2007.00168.x - Toz E, Sanci M, Ozcan A, Beyan E, Inan AH. Comparison of classic terminology with the FIGO PALM-COEIN system for classification of the underlying causes of abnormal uterine bleeding. Int J Gynaecol Obstet. 2016;133(3):325-328. doi: 10.1016/j.ijgo.2015.09.033 - Wouk N, Helton M. Abnormal uterine bleeding in premenopausal women. Am Fam Physician. 2019;99(7):435-443. - Munro MG, Critchley HO, Fraser IS. The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them? Am J Obstet Gynecol. 2012;207(4):259-265. doi: 10.1016/j.ajog.2012.01.046 - Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-390. doi: 10.1055/s-0031-1287662 - Woolcock JG, Critchley HO, Munro MG, Broder MS, Fraser IS. Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding. Fertil Steril. 2008;90(6):2269-2280. doi: 10.1016/j.fertnstert.2007.10.060 - Fraser IS, Critchley HO, Munro MG, Broder M, Writing Group for this Menstrual Agreement Process. A process designed to lead to international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding. Fertil Steril. 2007;87(3):466-476. doi: 10.1016/j.fertnstert.2007.01.023 - Fraser IS, Critchley HO, Munro MG, Broder M. Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod. 2007;22(3):635-643. doi: 10.1093/humrep/del478 Details Primary Language English Subjects Obstetrics and Gynaecology Journal Section Erratum Publication Date June 18, 2025 Submission Date - Acceptance Date - Published in Issue Year 2025 Volume: 6 Number: 3

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