Analysis of the Reasons for Postmenopausal Bleeding that Originated from the Uterus

Baki Erdem, Bulat Aytek Sik, Bulent Tekin, Yucel Ozdemir, Suleyman Salman
2016 Journal of Academic Research in Medicine  
Objective: We aimed to analyze the reasons for postmenopausal bleeding that originated from the uterus in cases who consulted our menopausal clinic. Methods: Sixty-eight patients who visited the Gaziosmanpaşa Taksim Training and Research Hospital meopausal clinic with the complaint of postmeopausal bleeding were included in this prospective study. Systematic and gynecological examinations were conducted on these patients when they first visited. The age of the patients, last menstruation dates,
more » ... characteristics of the vaginal bleeding, whether the patients had undergone hormone replacement treatment or not, number of pregnancies, whether they had a systematic disease or not, and alcohol consumption and smoking were investigated and recorded. Patients who had uterine bleeding that originated from the vagina and that was related to a systematic disease were excluded. The patients' vagina and vulva were examined, with the patient in the dorsolithotomy position on the gynecological table. Each patient underwent a smear test, followed by a transvaginal ultrasound. Results: The average age of the 68 patients who were included was 57 years, with the youngest aged 45 years and the oldest aged 83 years. As a result of the sampling done with these 68 patients, endometrium cancer was observed in six of them, with three of them aged over 65 years. In our study, 8.8% patients were detected with endometrium cancer. There are six nullipara patients according to the number of births and four of them were diagnosed with endometrium cancer. The menopause period of five of these six patients who were diagnosed with endometrium cancer was over 10 years. For the other reasons of postmenopausal bleeding, it was detected that atrophy in our series was 41.2%, hyperplasia was 7.4%, polyp was 35.3%, submucous myoma was 2.9%, cervical cancer was 2.9%, and cervical intraepithelial neoplasia-2 was 1.5%. In one of the cases who was diagnosed with endometrium cancer, the thickness of the endometrium was detected as 11 mm, and in the rest of the cases, this thickness was 20 mm. Conclusion: Beside obviously seeing the benefit of getting a prior knowledge for the patients about the endometrium by detecting the thickness of the endometrium by conducting transvaginal ultrasonography on the patients who have postmenopausal bleeding, in the postmenopausal bleeding, endometrial curettage is the golden standard. (JAREM 2016; 6: 78-83)
doi:10.5152/jarem.2015.808 fatcat:xyafuy4lhzbffos6zcc55iwolu