PALM-COEIN classification system of FIGO vs the classic terminology in patients with abnormal uterine bleeding

Abstract

Objectives: To evaluate the FIGO’s novel classification system versus the classic terminology in patients with abnormal uterine bleeding. Material and methods: A retrospective study was carried out between August 2015 and September 2019 in the Health Sciences University Gazi Yaşargil Training and Research Hospital. The pathology reports of the patients were classified according to the PALM-COEIN method and were compared with classical terminology. The operated patients with fibroids reported in the pathology results were classified as subgroups of fibroids. Results: Evaluation was made of a total of 515 women with abnormal uterine bleeding. According to the classical terminology, 137 (26.6%) patients were defined with hypermenorrhea, 74 (14.4%) with menorrhagia, 57 (11.1%) with metrorrhagia, and 246 (47.8%) with menometrorrhagia. In the PALM-COEIN classification system, polyps were determined in 84 (16.3%) cases, adenomyosis in 228 [diffuse adenomyosis:196 (38.1%), local adenomyosis:32 (6.2%)], leiomyoma in 386 [submucous:161 (31.1%), other types: 225 (43.9%)], and malignancy and hyperplasia in 47 (9.1%). Conclusions: The classical terminology for abnormal uterine bleeding is insufficient in terms of etiological pathologies in non-pregnant women of reproductive age. The widespread use of this novel system for the abnormal uterine bleeding classification will provide a more useful communication between physicians and researchers.