Comparison of classic terminology with the FIGO PALM‐COEIN system for classification of the underlying causes of abnormal uterine bleeding

Emrah Töz, Sancı M, Muzaffer Sancı, Muzaffer Şancı, Özcan A, Aykut Özcan, Emrah Beyan, Abdurrahman H İnan, Abdurrahman Hamdi İnan
International Journal of Gynecology & Obstetrics · 2016 · vol. 133(3) , pp. 325–328 · doi:10.1016/j.ijgo.2015.09.033 · PMID:26952349 · W2275992781
article OA: closed CC0 ⤵ 2 in-corpus citations
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This study compared classic terminology with the PALM-COEIN system for abnormal uterine bleeding in women undergoing surgery, finding classic terms insufficient and recommending PALM-COEIN for clearer communication.

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Abstract

OBJECTIVE: To compare classic terminology and the PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory disorders, endometrium, iatrogenic, and not classified) classification system among women who underwent surgery for abnormal uterine bleeding (AUB), and to subclassify the components of the PALM group for future studies. METHODS: In a retrospective study, data were obtained for nonpregnant women aged 18-55years who underwent hysterectomy, myomectomy, or polypectomy for AUB at a center in Turkey in 2014. The patients were retrospectively classified according to the PALM-COEIN system, and the two terminologies were compared. RESULTS: A total of 471 women were included. The term "hypermenorrhea" covered 15 different pathology combinations, "menorrhagia" nine, "metrorrhagia" 14, and "menometrorrhagia" 18. Of 92 patients with polyp, 5 (5.4%) had two polyps and 1 (1.1%) had three. Of 146 patients with adenomyosis, 131 (89.7%) had diffuse adenomyosis and 12 (8.2%) had adenomyoma. Of 309 patients with myoma uteri, 108 (34.9%) had submucous myoma and 201 (65.1%) had other types of myoma. CONCLUSION: Classic terminology for AUB is insufficient and confusing with respect to etiologic pathologies among nonpregnant women of reproductive age. Widespread adoption of the PALM-COEIN system for AUB classification will facilitate more meaningful communication among both clinicians and investigators, and clarify the populations that should be evaluated in clinical trials, thereby enhancing communication with patients.

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Condition tags

adenomyosis

MeSH descriptors

Leiomyoma Menorrhagia Metrorrhagia Terminology as Topic Uterine Hemorrhage Uterine Hemorrhage Adenomyosis Adenomyosis Adult Endometrium Endometrium Female Humans Hysterectomy Hysterectomy Leiomyoma Menorrhagia Metrorrhagia Middle Aged Polyps

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