A study on histopathological spectrum of hysterectomy specimens for abnormal uterine bleeding in a tertiary hospital in Madhya Pradesh

Mamta Arora, Swati Arora, Ani Chandanan
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2026 · vol. 15(4) , pp. 1220–1224 · doi:10.18203/2320-1770.ijrcog20260876 · W7142491945
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This study examined 100 hysterectomy specimens for abnormal uterine bleeding, finding leiomyoma, chronic cervicitis, and follicular cysts most common, along with two cases of malignancy.

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This tertiary-hospital study evaluated the histopathological spectrum of uterine, cervical, and ovarian findings in 100 reproductive-age, perimenopausal, and post-menopausal patients who underwent abdominal hysterectomy for abnormal uterine bleeding in Madhya Pradesh over 14 months. Heavy menstrual bleeding was the most common presentation, and the most frequent histopathology included uterine leiomyoma, chronic cervicitis of the cervix, and follicular cysts of the ovaries. The paper reports that malignancy was detected on histopathology in two cases, including one endometrial carcinoma and one leiomyosarcoma, and it emphasizes that preoperative assessment can miss such findings. The paper includes adenomyosis only as a keyword rather than as a detailed focus of the results, but it relates to endometriosis/adenomyosis through its evaluation of hysterectomy specimens for abnormal uterine bleeding and its listing of adenomyosis among relevant pathologies.

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Abstract

Background: AUB (abnormal uterine bleeding) impacts the quality of life of women. Leiomyoma and adenomyosis are the most common cause of AUB. For exact diagnosis, histopathological examination of hysterectomy specimen is required. Sometimes in histopathology we find carcinomas and other pathologies. So, it is clear that histopathogical examination of the hysterectomy specimen should always be done. In our study also we had two cases of carcinoma detected on histopathology. Methods: In our study we took 100 patients coming to Obstetrics and Gynaecology department at Sukh Sagar Medical College and Hospital for a period of fourteen months from March 2024 to May 2025. A total of 100 patients of reproductive age group, perimenopausal and post-menopausal women with diagnosis of abnormal uterine bleeding who underwent abdominal hysterectomy were taken. Results: A total of 100 cases were included in our study. Maximum number of patients were in the 36-42 years age group. Heavy menstrual bleeding was the commonest clinical presentation. Leiomyoma in the uterus, chronic cervicitis in the cervix and follicular cysts in the ovaries were the commonest histopathology noted. One specimen showed endometrial carcinoma and one specimen had leiomyosarcoma. Conclusions: The findings in present study emphasise the importance of histopathological examination of all hysterectomy specimens to detect malignancies even in the cases which suggest a benign pathology on preoperative assessment.
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Background

AUB (abnormal uterine bleeding) impacts the quality of life of women. Leiomyoma and adenomyosis are the most common cause of AUB. For exact diagnosis, histopathological examination of hysterectomy specimen is required. Sometimes in histopathology we find carcinomas and other pathologies. So, it is clear that histopathogical examination of the hysterectomy specimen should always be done. In our study also we had two cases of carcinoma detected on histopathology.

Methods

In our study we took 100 patients coming to Obstetrics and Gynaecology department at Sukh Sagar Medical College and Hospital for a period of fourteen months from March 2024 to May 2025. A total of 100 patients of reproductive age group, perimenopausal and post-menopausal women with diagnosis of abnormal uterine bleeding who underwent abdominal hysterectomy were taken.

Results

A total of 100 cases were included in our study. Maximum number of patients were in the 36-42 years age group. Heavy menstrual bleeding was the commonest clinical presentation. Leiomyoma in the uterus, chronic cervicitis in the cervix and follicular cysts in the ovaries were the commonest histopathology noted. One specimen showed endometrial carcinoma and one specimen had leiomyosarcoma.

Conclusions

The findings in present study emphasise the importance of histopathological examination of all hysterectomy specimens to detect malignancies even in the cases which suggest a benign pathology on preoperative assessment. Metrics

References

Misra M, Srivastava S. Prevalence and clinical spectrum of abnormal uterine bleeding in a tertiary care hospital. New Indian J OBGYN. 2023:1-6. Munro MG, Critchley HO, Fraser IS; FIGO Menstrual Disorders Working Group. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Int J Gynaecol Obstet. 2011;95(7):2204-8. DOI: https://doi.org/10.1016/j.fertnstert.2011.03.079 Munro MG, Critchley HO, Broder MS, Fraser IS, FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113(1):3-13. DOI: https://doi.org/10.1016/j.ijgo.2010.11.011 Bhosle A, Fonseca M. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. Bombay Hosp J. 2010;52(1):69-72. Wankhade R, Dawande P. Histopathological analysis of hysterectomy specimens in a tertiary care centre: a retrospective study. Cereus. 2023;15(12). DOI: https://doi.org/10.7759/cureus.50497 Gul G, Manzoor R, Lone IR. Abnormal uterine bleeding and hysterectomy: Insights from histopathological analysis of hysterectomy specimens from a tertiary care hospital. Indian J Pathol Oncol. 2024;11(3):232-237. DOI: https://doi.org/10.18231/j.ijpo.2024.053 Santharam M, Sekar P, Karthikeyan TM, Kandaswamy S. A study on histomorphological spectrum in abnormal uterine bleeding at a tertiary care center. Natl Board Examinations J Med Sci. 2025;3(1):39-48. DOI: https://doi.org/10.61770/NBEJMS.2025.v03.i01.006 Seetha PM, Venetia A, Haridas N. A study on distribution of causes of non-gestational abnormal uterine bleeding in reproductive age group as per the FIGO classification in a tertiary care centre. Int J Clin Obstet Gynaecol. 2020;4(1):84-7. DOI: https://doi.org/10.33545/gynae.2020.v4.i1b.445 Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynecol Obstet. 2018;143(3):393-408. DOI: https://doi.org/10.1002/ijgo.12666 Jose AA, Daniel M, Phansalkar MD. Hysteropathological correlation in abnormal uterine bleeding in a tertiary care hospital in South India. J Obstet Gynaecol India. 2024;74(2):150-7. DOI: https://doi.org/10.1007/s13224-023-01888-z Shergill SK, Shergill HK, Gupta M, Kaur S. Clinicopathological study of hysterectomies. J Indian Med Assoc. 2002;100(4):238-9. Pandya B, Gandhi H, Rathod G, Parmar P. Histopathological analysis of hysterectomy specimens. Natl J Physiol Pharm Pharmacol. 2022;12(11):1907-10. DOI: https://doi.org/10.5455/njppp.2022.12.03110202220032022 Shrivastava K, Mishra RT, Tiwari P, Totade S, Dhakar J. Histopathological spectrum of uterine lesions in hysterectomy specimens of patients with abnormal uterine bleeding. Int J Clin Trials. 2024;11(4):252-9. DOI: https://doi.org/10.18203/2349-3259.ijct20242672

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