Study of clinical and pathological correlation of AUB patients undergoing hysterectomy

Abstract

Background: Abnormal uterine bleeding (AUB) is most common in the perimenopausal and postmenopausal age groups. FIGO's acronym (PALM-COEIN) describes the causes of AUB. Polyps, adenomyosis, leiomyoma, malignancy, hyperplasia, coagulopathy, Ovulatory dysfunction, endometrial, iatrogenic, and not yet classified are among them. Aim: To determine the prevalence and distribution of various uterine pathologies in hysterectomy specimens as a function of age, parity, and clinical characteristics. Methods: 500 women with AUB who are having a hysterectomy between December 2017 and November 2019 will be chosen for the study. All AUB patients undergoing hysterectomy were included in the study. Results: In the present study, majority of patients were in the age group range of 41-50 years (37%) followed by 30% in the age group range of 31-40 years. Majority of patients were in the 2nd parity which constituted 58% and minimum number of cases (2%) in unmarried cases. HMB was seen (47.6%) followed by dysmenorrhoea (14%) and irregular bleeding (13.4%) cases. The most common diagnoses were fibroid uterus in 40% of cases, Adenomyosis in 17% of cases, both fibroid and Adenomyosis in 8.2% of cases, polyp in 5% of cases, normal uterus in 14.6 percent of cases, endometrial hyperplasia in 1.6 percent of cases, endometrial carcinoma in 1.2 percent of cases. The most common surgical approach is abdominal (66.2%), followed by vaginal (18.6%), and laparoscopically (15.2 percent). In 102 cases, complications were discovered (19.25 percent). Pyrexia in 28 instances (5.6%), abdominal distension in 17 cases (3.4%), wound dehiscence in 15 cases (3%), RTI in 11 cases (2.6%), and UTI in 13 cases are the most common complications (2.6 percent). Malaria, thrombophlebitis, urinary retention, and subsequent haemorrhage have all been reported in a small number of patients. Conclusion: The majority of the patients were in the perimenopausal age bracket and were multiparous. HMB was a common AUB symptom. Leiomyoma was a common diagnosis. USG and histology confirmed the diagnosis. Proliferative endometrial patterns were common. Simple endometrial hyperplasia in perimenopausal women and complicated hyperplasia in postmenopausal women were the most common findings. In AUB patients, hysterectomy is still the only option.