Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium

Abstract

BACKGROUND Postmenopausal bleeding and an endometrial thickness ≥ 5 mm on sonograms ofmenopausal women can indicate the presence of endometrial lesions. Diagnostichysteroscopy is a powerful method for endometrial diseases.AIMTo investigate the pathological pattern of endometrial abnormalities in postmeno-pausal women with bleeding or asymptomatic thickened endometrium diagnosedby hysteroscopy.METHODSA total of 187 postmenopausal women with bleeding or asymptomatic thickenedendometrium underwent diagnostic hysteroscopy. The women weresubsequently divided into three groups: Postmenopausal bleeding (PMB) group (n = 84), asymptomatic group (n = 94), and additional group (n = 9). Women in theadditional group manifested abdominal pain and leukorrhagia.RESULTSAmong the 187 patients examined, 84 (44.9%) were diagnosed with PMB and 94(50.3%) with asymptomatic thickened endometrium. Endometrial polyp was themost common endometrial abnormality, which was detected in 51.2%, 76.6% and77.8% of the PMB, asymptomatic, and additional groups, respectively. In the PMBgroup, 7 (8.3%) women had hyperplasia with atypia and 14 (16.7%) hadendometrial adenocarcinoma. Fewer malignant lesions were detected in theasymptomatic group. Endometrial hyperplasia without atypia was found in 8.3%of the PMB group and 7.4% of the asymptomatic group.CONCLUSIONEndometrial polyp was the most common pathology in the PMB group.Diagnostic hysteroscopy is recommended for women with PMB and asymp-tomatic thickened endometrium.