Clinical and pathological analysis of postmenopausal women with abnormal uterine bleeding

doi:10.3969/j.issn.1006-7795.2021.06.026

Abstract

Abstract: Objective To explore the best clinical diagnosis and treatment method of abnormal uterine bleeding after menopause. Methods Sixty two postmenopausal women with abnormal uterine bleeding were analyzed retrospectively,who underwent transvaginal ultrasound, hysteroscopy and / or surgery and histopathology from January 31, 2019 to January 31, 2020. Results In the 62 women diagnosed by hysteroscopy, there were normal endometrium (including atrophic endometrium and proliferative endometrium) in 13 cases, with endometrial thickness less than 10 mm. There were 41 cases of benign uterine lesions, and in the endometrial thickness of <5 mm,5-10 mm and >10 mm, the incidence rate was similar. Endometrial atypical hyperplasia and endometrial carcinoma were 8 cases. With the increase of endometrial thickness, the incidence rate increased gradually. The coincidence rate between hysteroscopic diagnosis and postoperative pathological examination was 91.9%. Conclusion For the women with abnormal uterine bleeding after menopause, hysteroscopy and direct vision biopsy are recommended to make early diagnosis and treatment for intrauterine lesions.

Key words: abnormal uterine bleeding in postmenopausing, hysteroscopy, histopathology examination

CLC Number:

R711.52

Li Yunfei, Xia Enlan, Huang Xiaowu. Clinical and pathological analysis of postmenopausal women with abnormal uterine bleeding[J]. Journal of Capital Medical University, 2021, 42(6): 1060-1064.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.06.026

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I6/1060

References

[1] Van Hanegem N, Breijer M C, Khan K S, et al. Diagnostic evaluation of the endometrium in postmenopausal bleeding: an evidence-based approach[J]. Maturitas, 2011, 68(2): 155-164.
[2] Bignardi T, Van Den Bosch T, Condous G. Abnormal uterine and post-menopausal bleeding in the acute gynaecology unit[J]. Best Pract Res Clin Obstet Gynaecol, 2009, 23(5): 595-607.
[3] Singh P, Dwivedi P, Mendiratta S. Correlation of endometrial thickness with the histopathological pattern of endometrium in postmenopausal bleeding[J]. J Obstet Gynaecol India, 2016, 66(1): 42-46.
[4] Timmermans A, Van Doorn L C, Opmeer B C, et al. Follow-up of women after a first episode of postmenopausal bleeding and endometrial thickness greater than 4 millimeters[J]. Obstet Gynecol, 2008, 111(1): 137-143.
[5] Goldstein S R. The role of transvaginal ultrasound or endometrial biopsy in the evaluation of the menopausal endometrium[J]. Am J Obstet Gynecol, 2009, 201(1): 5-11.
[6] 吴鸣, 沈铿, 郎景和. 绝经后子宫出血与子宫内膜癌的相关因素分析[J]. 中华妇产科杂志, 2005, 40(7): 487-488.
[7] Chandavarkar U, Kuperman J M, Muderspach L I, et al. Endometrial echo complex thickness in postmenopausal endometrial cancer[J]. Gynecol Oncol, 2013, 131(1): 109-112.
[8] Piróg M, Kacalska-Janssen O, Bereza T, et al. The thin red line-postmenopausal abnormal uterine bleeding with endometrial thickness less than 4 mm[J]. Contemp Oncol: Pozn, 2019, 23(1): 43-46.
[9] Li Y H, Feng T, Sun J D. Evaluation of clinical effect of transabdominal sonography and transvaginal sonography in early diagnosis of ectopic gestation[J]. Pak J Med Sci, 2017, 33(1): 53-58.
[10] Peitsidis P, Manolakos E, Tsekoura V, et al. Uterine arteriovenous malformations induced after diagnostic curettage: a systematic review[J]. Arch Gynecol Obstet, 2011, 284(5): 1137-1151.
[11] Du J, Li Y L, Lv S L, et al. Endometrial sampling devices for early diagnosis of endometrial lesions[J]. J Cancer Res Clin Oncol, 2016, 142(12): 2515-2522.
[12] 胡倩, 梁琳, 伍凤莉, 等. 老年女性子宫内膜病变特点及宫腔镜检查的诊断价值[J]. 中华老年医学杂志, 2018, 37(3): 311-314.
[13] Trojano G, Damiani G R, Casavola V C, et al. The role of hysteroscopy in evaluating postmenopausal asymptomatic women with thickened endometrium[J]. Gynecol Minim Invasive Ther, 2018, 7(1): 6-9.
[14] Sarvi F, Alleyassin A, Aghahosseini M, et al. Hysteroscopy: a necessary method for detecting uterine pathologies in post-menopausal women with abnormal uterine bleeding or increased endometrial thickness[J]. Turk J Obstet Gynecol, 2016, 13(4): 183-188.
[15] 彭爱云. 探讨阴道超声与宫腔镜对绝经后子宫出血的诊断价值[J]. 影像研究与医学应用, 2018, 2(1): 146-147.
[16] 张倩, 何文杰, 宋蕾, 等. 经阴道超声联合宫腔镜技术诊断绝经后子宫出血价值[J]. 中国计划生育学杂志, 2020, 28(10): 1685-1687.
[17] 王丽, 郭艳平, 赵娟, 等. 区分绝经后出血女性子宫内膜癌和内膜增生的超声预测模型[J]. 山西医科大学学报, 2019, 50(6): 817-821.
[18] 方芳,吕丹.宫腔镜下子宫内膜活检及分段诊刮术在子宫内膜癌早期诊断中的应用价值[J].解放军医药杂志,2020,32(12):23-26.
[19] 黄文阳,郑晓娟,蒋英,等.子宫内膜不典型增生患者术后病理升级的特征分析[J].首都医科大学学报,2019,40(6):846-850.