Endometrial pathology in postmenopausal women with no bleeding

Mine Genç, M Genc, B Genc, B. Genç, Nur Şahin, N Sahin, Zeliha Esin Çelik, E Celik, Gülcan Atıcı Turan, G A Turan, Esra Bahar Gür, E B Gur, S Guclu
Climacteric : the journal of the International Menopause Society · 2014 · vol. 18(2) , pp. 241–245 · doi:10.3109/13697137.2014.944152 · PMID:25017611 · W2042426221
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Abstract

OBJECTIVE: The aim of this study was to determine the rate of unexpected uterine pathology in postmenopausal women admitted to a gynecology clinic with symptoms other than vaginal bleeding and who were scheduled to undergo hysterectomy. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 283 postmenopausal patients who had gynecological surgery between September 2007 and January 2014. We reviewed their presenting symptoms on admission, the indications for surgery, and their transvaginal ultrasonographic findings. Postoperative histopathological results based on uterine specimens were also recorded. The results were analyzed statistically. RESULTS: Of 283 patients who had surgery, 209 had no vaginal bleeding at the time of admission. From this group, 75.6% were found to have unsuspected pathology, including endometrial hyperplasia, endometrial polyps, uterine fibroids, adenomyosis, and one case of endometrial carcinoma (0.5%). The remaining 74 patients had experienced postmenopausal bleeding and in 87.8% there were pathological findings including 13 cases (17.6%) of endometrial cancer (p = 0.0001). CONCLUSION: Vaginal bleeding in postmenopausal women is indicative of a wide array of gynecological pathologies, including endometrial carcinoma. However, uterine fibroids, pelvic masses, or even endometrial cancer may develop without co-morbid vaginal bleeding. Therefore we advocate that postmenopausal women should undergo yearly screening and consultation, without waiting for an episode of vaginal bleeding.

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Condition tags

adenomyosis

MeSH descriptors

Endometrium Postmenopause Uterine Hemorrhage Adenomyosis Adenomyosis Adult Aged Aged, 80 and over Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Neoplasms Endometrial Neoplasms Endometrium Endometrium Female Humans Hysterectomy Leiomyoma Leiomyoma Middle Aged

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