Hysteroscopic Findings in Postmenopausal Bleeding and its Correlation with Histopathology: Does Clinical Experience Matter?

Radwa Rasheedy,Ahmed Abbas

doi:10.21608/ejgg.2018.30882

Abstract

AbstractBackground: women with PMB have a 10–15% chance of having endometrial carcinoma. Therefore, prompt and accurate evaluation to exclude malignant or premalignant lesions of the endometrium is necessaryAim: To evaluate different hysteroscopic findings in women with PMB and its correlation with histopathological finding in early and late postmenopausal women.Methods: This retrospective observational study was carried out in early cancer detection unit (ECDU) in Ain Shams University Maternity Hospital between June 2017 and December 2017 involving medical records of 83 women presented with PMB who underwent hysteroscopy and endometrial sampling. We identified hysteroscopic appearance of the endometrium and any focal lesion then the findings were later correlated with the final histopathological diagnosis.Results: the commonest hysteroscopic appearance of the endometrium was thick hypertrophic endometrium (59.6% in early postmenopausal years group A and 61.5% in late postmenopausal years group B). Benign pathology was observed in 50 women (87.7%) in group A and in14 women (53.8%) in group B, malignant and premalignant lesions were found in 7% and 30.8% respectively. Inadequate samples occurred in 5.3% and 15.4% of women in group A and B respectively. Hysteroscopic sensitivity in detecting malignant lesions was 83.3%, while its Specificity was 96.87%Conclusions: Hysteroscopy is an accurate and reliable method for diagnosing endometrial cancers, and offers a good immediate therapeutic option for women with obvious benign lesions as endometrial polyp. There is no difference in hysteroscopic accuracy in detecting malignancy with different operators’ clinical experiences.

Highlights

With increasing life expectancy, a healthy 50-year-old woman will spend around 40% of her life in postmenopausal state[1]
There is no difference in hysteroscopic accuracy in detecting malignancy with different operators’ clinical experiences
Between June 2017 and December 2017, eighty three women underwent office hysteroscopy for evaluation of Postmenopausal bleeding (PMB) in the Early Cancer Detection Unit (ECDU) at Ain Shams University Maternity Hospital and they were divided into 2 groups according to the age into

Summary

Introduction

A healthy 50-year-old woman will spend around 40% of her life in postmenopausal state[1]. Postmenopausal bleeding (PMB) is any abnormal uterine bleeding occurring after at least 1 year of amenorrhea, it accounts for about 5 percent of office gynecology visits .2. 5. The aim of this study was to evaluate different hysteroscopic findings in women with PMB and its correlation with histopathological findings in early and late postmenopausal women. The aim of this study was to evaluate different hysteroscopic findings in women with PMB and its correlation with histopathological findings in early and late postmenopausal women Another aim was to evaluate the impact of years of clinical experience on accuracy of hysteroscopic diagnosis of endometrial cancer

Objectives

Methods

Results

Conclusion