CLINICOPATHOLOGICAL STUDY OF POSTMENOPAUSAL BLEEDING.

Abstract

Abnormal uterine bleeding is frequent in gynecological complaint and accounts approximately 5-10% of postmenopausal women. About 10% of women with postmenopausal bleeding have a primary or secondary malignancy. Common malignancies among them are endometrial cancer, cervical cancer or an ovarian cancer. The incidence of malignancy in postmenopausal period remains sufficiently high so it requires immediate investigation for early diagnosis, vigilant follow up and prompt treatment. Aims and Objectives: To ascertain etiological factors of postmenopausal bleeding and to investigate its clinical significance in terms of incidence of malignancy and histopathological evaluation. Materials and Method: A total 100 patients with postmenopausal bleeding per vaginum attending the outpatient department or admitted for evaluation under Obstetrics and Gynaecology Department, VSSIMSAR, Burla, Sambalpur, Odisha over a period of two years from November 2014 to October 2016 were selected and studied. Results: The average of PMB was 56.68 years with highest incidence of cases between 55-65 years (52%). The incidence of malignancy was 57% out of which carcinoma cervix was found to be the most common malignancy causing postmenopausal bleeding representing 46% of total cases and 81% of total malignancies. Carcinoma endometrium found in 12% cases among total malignancies, resulting in carcinoma endometrium : carcinoma cervix ratio to be 1:7. On histopathology, we found atrophic endometrium in 49% ,proliferative endometrium in 6% of cases and hyperplasia in 14% of cases. Conclusion: Carcinoma of genital tract is one of the most important cause of PMB, so early detection of the causes can be life saving. Endometrial sampling is a cost effective procedure to rule out endometrial carcinoma /detect in very early stage. . Copy Right, IJAR, 2017,. All rights reserved.