Abstract
Background: Incidence of endometrial carcinoma in Vojvodina is 15-20/100 000. In 75% cases, endometrial carcinoma is diagnosed in postmenopausal period. In 90 % of patients, the first clinical sign is postmenopausal bleeding. The aim of the study was to investigate clinical and histopathological characteristics in patients with postmenopausal bleeding. Methods: The study included 122 patients with postmenopausal bleeding. All of these patients underwent gynecological examination and vaginal ultrasound. We obtained materials for histopathological analysis by fractionate explorative curettage. Once we had definitive histopathological findings, we divided patients in two groups A (endometrial carcinoma) and B (benign changes). Results: We confirmed significant statistical differences between examined group A and B, including age (64.49 compared with 58.81 years), postmenopausal period (13.67 instead 9.11 years), and length of uterine corpus (6.41 instead 5.25 cm). Conclusion: Elderly women with longer postmenopausal interval and postmenopausal bleeding had increased risk for endometrial carcinoma. Measurement of endometrial thickness by transvaginal ultrasound appeared to be insufficient parameter for differentiating the benign from the malignant changes of endometrium. Patients with endometrial carcinoma had significantly longer corpus of uterus comparing to patients with benign changes. Body mass index was not found to be significant risk factor in development of endometrial carcinoma in the examined groups. Obesity was diagnosed in both groups, suggesting that increased body mass index is a risk factor for development of pathological changes in endometrium, which could lead to postmenopausal bleeding.
Highlights
Postmenopausal bleeding (PMB) is vaginal bleeding in postmenopausal women, which is different from that we expect in women who use sequential hormonal substitution therapy [1]
We confirmed significant statistical differences between examined group A and B, including age (64.49 mandic.aljosa@onk.ns.ac.rs compared with 58.81 years), postmenopausal period (13.67 instead 9.11 years), and length of uterine corpus (6.41 instead 5.25 cm)
75% of endometrial cancers occur in postmenopausal period, and 50 % of these are associated with risk factors [7]
Summary
Postmenopausal bleeding (PMB) is vaginal bleeding in postmenopausal women, which is different from that we expect in women who use sequential hormonal substitution therapy [1]. 75% of endometrial cancers occur in postmenopausal period, and 50 % of these are associated with risk factors [7]. Possibility that the postmenopausal bleeding is caused by endometrial cancer depends on patients age and it is diagnosed at approximately 9% of women 50 years old, 16% women 60 years old, 28% those of 70 years, and 60% at women of 80 years [9]. It is necessary examine every PMB and find out the cause of it. Basic diagnostic approach considers [9]: – Anamnesis and gynecological examination – Transvaginal ultrasound – Methods of sampling endometrial tissue for histopathological analysis – Additional diagnostic methods
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