Clinicopathological Study of Postmenopausal Bleeding in a Tertiary Care Center

Abstract

Postmenopausal bleeding (PMB) requires complete assessment in order to ensure the absence of malignancy and to identify and treat high-risk patients such as those with endometrial hyperplasia. To enumerate the age predilection, histopathological diagnosis, incidence of malignancies, and management of postmenopausal bleeding. This is a prospective study done in department of gynecological oncology of a tertiary care center. A total of 50 patients of PMB were included for study. The mean age of reaching menopause was 48.02 years. The age range of study population was between 40 and 70 years. The mean age of patients was 56.26 with peak incidence of malignancy observed in age-group of 55–70 years. The histopathological analysis showed proliferative endometrium (16%), simple hyperplasia (8%), complex hyperplasia with atypia (6%), CIN 3(6%), and carcinoma in situ of cervix (2%). Incidence of cervical, endometrial carcinoma, sarcoma of uterus, and vulval cancer was 48, 8, 2, and 2%, respectively. Conservative management was done in 26% cases in proliferative endometrium, hyperplasia without atypia and cervicitis. Out of 26 cases of cervical cancer, 20 cases were referred to radiotherapy department as they presented in advanced stage and six underwent Wertheim’s hysterectomy. PMB is a sinister complaint. It requires careful and timely assessment to eliminate the possibility of malignancy. The risk of endometrial malignancy increases with age. High cervical cancer preponderance stresses the need for education of patients regarding screening and early diagnosis.