Using narrow-band imaging with conventional hysteroscopy increases the detection of chronic endometritis in abnormal uterine bleeding and postmenopausal bleeding

2015 ◽  
Vol 42 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Mustafa Ozturk ◽  
Mustafa Ulubay ◽  
Ibrahim Alanbay ◽  
Uğur Keskin ◽  
Emre Karasahin ◽  
...  
Keyword(s):  
Narrow Band ◽  
Narrow Band Imaging ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Postmenopausal Bleeding ◽  
Chronic Endometritis

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

Hysteroscopy in women with abnormal uterine bleeding on hormone replacement therapy: a comparison with postmenopausal bleeding

1996 ◽  
Vol 65 (6) ◽  
pp. 1145-1150 ◽  
Author(s):  
Fritz Nagele ◽  
Hugh O’Connor ◽  
Thomas F. Baskett ◽  
Anthony Davies ◽  
Hossam Mohammed ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Postmenopausal Bleeding

scholarly journals Chronic endometritis and endometriosis: is there an interrelationship?

2021 ◽  
Vol 10 (3) ◽  
pp. 83-91
Author(s):  
N.Y. Pedachenko ◽  
R.A. Tukhtarian ◽  
I.L. Avetis'yan ◽  
T.L. Shemelko
Keyword(s):  
Pelvic Pain ◽  
Medical Information ◽  
Clinical Symptoms ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cochrane Library ◽  
Control Group ◽  
Chronic Endometritis ◽  
Timely Diagnosis ◽  
Inflammatory Processes

Background. Chronic endometritis and endometriosis have a lot in common. Both diseases are long-term inflammatory processes, with definitively unspecified etiological factors and pathogenetic mechanisms that negatively affect fertility and may cause pelvic pain or abnormal uterine bleeding. The issue of effective and timely diagnosis of chronic endometritis remains open due to the lack of specific clinical symptoms and clinical examination data. Assessment of current scientific evidence of the interrelationship between endometriosis and chronic endometritis. Materials and methods. A systematic search of scientific medical information has been conducted in English-language databases: MEDLINE, Scopus, Web of Science, Medline, The Cochrane Library, PubMed. Results. According to the review of various scientific studies that have recently been conducted, it has been found that patients with endometriosis statistically have a significantly higher risk of developing chronic endometritis by 1.3-2.5 times than women without endometriosis. Using a histological endometrial study and detection of CD138, chronic endometritis was found in 52.94 % of women in the endometriosis group and in 27.02 % of patients in the endometriosis-free group; the rate was significantly higher in the endometriosis group than in the control group (p = 0.0311). Moreover, 76% of women with endometriosis showed inflammatory processes of pelvic organs (compared to the control group, where inflammation was found in 38.4 % of women, p < 0.0001). Conclusions. Patients with endometritis demonstrate a positive correlation with development of endometriosis. Given the inability to establish a causal relationship between endometriosis and chronic endometritis, extended diagnosis is necessary to eliminate chronic endometritis, especially if women have abnormal uterine bleeding or chronic pelvic pain. The combination of histological and immunohistochemical endometrial examination methods has shown its effectiveness in timely diagnosis of chronic endometritis. Identifying and adequately treating this condition will help avoid unnecessary surgery.

scholarly journals Histopathological Findings of Endometrial Samples and its Correlation Between the Premenopausal and Postmenopausal Women in Abnormal Uterine Bleeding

2015 ◽  
Vol 12 (4) ◽  
pp. 275-278
Author(s):  
S Sharma ◽  
R Makaju ◽  
S Shrestha ◽  
A Shrestha
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Postmenopausal Bleeding ◽  
Related Condition ◽  
Histopathological Findings ◽  
Dilation And Curettage ◽  
Proliferative Endometrium ◽  
Specific Association ◽  
One Year

Background Abnormal uterine bleeding is considered as one of the most common problems among women. The therapy is incomplete without knowing the underlying pathology.Objectives To determine the types and frequency of endometrial pathologies in patients presenting with abnormal uterine bleeding at Dhulikhel Hospital Kathmandu university Hospital.Methods This is retrospective study total 100 cases were included over a period of one year of Abnormal Uterine bleeding.Results Out of 100 cases of Abnormal uterine bleeding, 61% were due to non-organic cause with a commonest histopathological findings proliferative endometrium. 27% cases were due to organic cause with pregnancy related condition as most common finding. 12% were reported as inadequate. The rate of postmenopausal bleeding declined with increasing age in the postmenopausal period and endometritis was the predominant finding.Conclusion There is an age specific association of Abnormal uterine bleeding with increased incidence in perimenopausal age group. Postmenopausal bleeding declined with increasing with endometritis the most common finding. Dilation and curettage is helpful to exclude other organic pathology. It is useful for diagnosis and to know pathological incidence of organic lesions in cases of Abnormal uterine bleeding prior to surgery.Kathmandu University Medical Journal Vol.12(4) 2014; 275-278

scholarly journals Evaluation of Endometrium for Chronic Endometritis by Using Syndecan-1 in Abnormal Uterine Bleeding

2012 ◽  
Vol 4 (02) ◽  
pp. 069-073 ◽  
Author(s):  
Vidyavathi Kannar ◽  
Harendra Kumar Malligere Lingaiah ◽  
Venigalla Sunita
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Proliferative Endometrium ◽  
Stromal Edema ◽  
Clinically Significant ◽  
Mononuclear Infiltrate

ABSTRACT Context: Chronic endometritis is a condition observed in 3-10% of women with abnormal uterine bleeding (AUB). Diagnosis depends upon the histological detection of plasma cells within the inflammatory infiltrate in the endometrium. Plasma cells on H and E may be obscured by a mononuclear infiltrate, plasmacytoid stromal cells, abundant stromal mitosis, a pronounced predecidual reaction, menstrual features or secondary changes due to exogenous progesterone treatment prior to biopsy. Aims: The objective of this study was to determine utility of syndecan-1 in diagnosis of chronic endometritis in patients with AUB, and to see if any of the secondary histologic features in endometrial biopsy, correlated with the presence of plasma cells on immunohistochemistry (IHC). Materials and Methods: Fifty endometrial biopsies with a clinical diagnosis of AUB were taken. Endometrium in proliferative phase, secretory phase, endometrial polyps, and disordered proliferative endometrium were studied for the presence of plasma cells. IHC was done using syndecan-1. The secondary histologic features of chronic endometritis like gland architectural irregularity, spindled stroma, stromal edema and hemorrhage with the presence of plasma cells was statistically analysed. Values of P < 0.05 were considered as significant. Results: Plasma cells were seen in 11 (69%) of DPE, 8 (66%) of PEB, and 1 (7%) of normal proliferative endometrium and in 2 (40%) of secretory endometrium. Presence of stromal breakdown showed a significant association with plasma cells (P = 0.02) whereas gland architecture irregularity (P = 0.28), stromal edema (P = 0.71) and spindled stromal (P = 0.72) did not show a significant association. Conclusions: Plasma cells were significantly present in AUB patients. Syndecan-1 maybe helpful in unusual cases, where chronic endometritis is suspected as the cause of clinically significant ongoing abnormal bleeding.

scholarly journals Clinicopathological analysis of AUB in perimenopausal and postmenopausal women in cancer care centre: special reference to carcinoma endometrium

2021 ◽  
Vol 10 (7) ◽  
pp. 2739
Author(s):  
Varsha Deshmukh ◽  
Afsha Suboohi ◽  
Archana Rathod ◽  
Jyoti Kodgire
Keyword(s):  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Total Sample ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Postmenopausal Bleeding ◽  
Medical College ◽  
Carcinoma Endometrium

Background: Abnormal uterine bleeding (AUB) may be defined as any variation from normal menstrual cycle including alteration in its regularity, frequency, duration of flow and amount of blood loss. Postmenopausal bleeding is a danger sign for malignancy. The study aimed to study the histopathology spectrum of hysterectomy specimens and bleeding patterns in perimenopausal women and postmenopausal women.Methods: It was a retrospective observational study done at Government Medical College and Cancer Hospital, Aurangabad (MS) from January 2017 to January 2021. Total sample size was 100 women. Perimenopausal and postmenopausal women undergoing hysterectomy were analysed for the age, parity, etieology, histology and the malignant changes.Results: 22 cases of AUB were observed in the age group of less than 40 years. 56% cases presented with heavy menstrual bleeding 58% cases had prolonged menstrual bleeding. 36% cases had endometrial cause (harmonal disturbances), 12 % had endometrial polyp and 35 cases out of 100 had endometrial carcinoma. Both type 1 and type 2 cases of carcinoma endometrium are seen in this study.Conclusions: Excessive uterine bleeding is a common gynaecological problem in all age groups with significant patient morbidity. The spectrum of endometrial lesions seen in AUB and cancer cases shows that the histopathological examination of endometrium is gold standard diagnostic tool in evaluation of AUB and postmenopausal bleeding and there is an age specific association of endometrial lesions.

scholarly journals Assessing cytokine status of patients with chronic endometritis combined with endometrial hyperplastic processes in reproductive period

2020 ◽  
Vol 10 (4) ◽  
pp. 762-768
Author(s):  
L. V. Tkachenko ◽  
N. I. Sviridova ◽  
N. A. Zharkin ◽  
N. A. Burova ◽  
E. B. Belan
Keyword(s):  
Histological Examination ◽  
Inflammatory Process ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cytokine Level ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cervical Canal ◽  
Chronic Endometritis ◽  
Group I ◽  
Group Ii

The goal of our study was to examine local and serum cytokine level involved in regulating inflammation in patients with chronic endometritis combined with endometrial hyperplastic processes. On admission, all patients underwent hysteroscopy with separate diagnostic curettage followed by histological examination of samples isolated from the uterine and cervical canal mucosa. Such manipulations were indicated due to abnormal uterine bleeding as well as suspected endometrial pathology based on ultrasound examination. According to the histological examination data of the endometrial samples, all patients were divided into two groups: group I contained 45 women with CE combined with PEG without atypia; group II — 38 patients with morphologically verified CEE combined with AEG without atypia. Level of IL-1P, IL-2, IL-6, IFNy, TNFa in biological fluids (aspirate from the uterus; serum) was measured by using enzyme-linked immunosorbent assay. We found that in both groups (91.1% and 89.6%, respectively) the vast majority of patients was hospitalized due to abnormal uterine bleeding. Oligomenorrhea alternated with intermenstrual bleeding (66.7% and 71.2%, respectively) and dominated in pattern of menstrual cycle disorders in the examined patients, whereas 11 (24.4%) and 7 (18.4%) patients from group I and II, respectively, were noted to suffer from severe menstrual bleeding. Overall, analyzing the data on cytokine level both in the uterine aspirate and serum evidences about ongoing inflammatory process found at examination time point. Upon that, such process was not only local, but also exhibited signs of a systemic inflammatory response. The data on cytokine level in the uterine aspirate from patients with CE coupled to PGE or CGE without atypia point at local inflammatory process characterized by significantly increased concentration of IL-ф, IL-2, IL-6, TNFa and IFNy. At the same time, higher level of IL-ф and IFNy in patients from group II might indicates that degree of morphological changes in the endometrium could affect the level of local cytokine production. Thus, the data obtained evidence that immune changes in chronic endometritis combined with non-atypical endometrial hyperplastic processes mostly occur locally. In this regard, measuring cytokine concentration in the uterine aspirate is a diagnostic predictor and serves as a sign for monitoring therapeutic effectiveness of therapy in this cohort of patients.

scholarly journals Chronic endometritis is an indication for the pregravid preparation

2018 ◽  
Vol 9 (2) ◽  
pp. 36-41 ◽  
Author(s):  
G. M. Savelyeva ◽  
S. A. Mikhalev ◽  
A. G. Konoplyannikov ◽  
L. M. Mikhaleva ◽  
I. I. Babichenko ◽  
...  
Keyword(s):  
Blood Circulation ◽  
Bacterial Culture ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Cervical Canal ◽  
Chronic Endometritis ◽  
Comprehensive Examination

The crucial role of chronic endometritis in the genesis of endometrial dysfunction has been currently established. The inflammatory process serves as a co-factor and leads to a decrease in the receptivity of the sex hormones of the endometrium due to impaired blood circulation of the tissue and fibrosis in the stroma of the endometrium. This article is devoted to the study of the morpho-functional state of the endometrium in women of the reproductive age with abnormal uterine bleeding, in whom endometritis was diagnosed pathomorphologically, which is important for clarifying indications for the pregravid preparation in the future. A comprehensive examination of patients with abnormal uterine bleeding includes: bacterial culture (PCR) of the cervical canal and uterine cavity, hormonal profile, ultrasound examination of the pelvic organs and a complex histological examination of the uterine biopsy at the 7–10th and 19–21st days of the menstrual cycle, followed by immunohistochemical examination with the use of antibodies to the receptors of estrogens and progesterone, glycodelin, CD138, CD4, CD8, CD20.

scholarly journals Histopathological spectrum of endometrial lesions in cases of abnormal uterine bleeding at a Tertiary Care Hospital.

2020 ◽  
Vol 27 (08) ◽  
pp. 1692-1696
Author(s):  
Namra Naeem ◽  
Afra Samad ◽  
Safia Sartaj ◽  
Muhammad Farooq ◽  
Nudrat Fayyaz ◽  
...  
Keyword(s):  
Urban Areas ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Care Hospital ◽  
Secretory Phase ◽  
Duration Of Symptoms ◽  
Chronic Endometritis ◽  
Proliferative Endometrium

Objectives: To assess histological spectrum of endometrial lesions in abnormal uterine bleeding at a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of Pathology, Multan Medical & Dental College, Multan and Faisalabad Medical University, Faisalabad. Period: January, 2019 to December, 2019. Material & Methods: Using non – probability purposive sampling technique. Results: A total of 238 ladies presenting with abnormal uterine bleeding were registered in our study. Mean age of these patients with AUB was 47.25 ± 5.57 years (ranging 21 years to 59 years), 158 (66.4%) were aged more than 45 years.  Eighty five (35.7%) were from rural areas while 153 (64.3%) from urban areas. Of these 238 females, 162 (68.1%) were illiterate and 76 (31.9%) were literate. Majority of patients i.e. 218 (91.6%) were married and mean duration of illness was 5.28 ± 3.89 months while 169 (71%) presented within 6 months of illness. Histopathological pattern revealed Proliferative phase endometrium was observed in 69 (29%), endometrial hyperplasia in 59 (24.8%), chronic endometritis in 40 (16.8%), secretory phase in 40 (16.8 %), atrophic endometrium in 30 (12.6%) and endometrial polyps in 10 (4.2%). Conclusion: Histological pattern revealed proliferative endometrium was commonest followed by hyperplasia, secretory phase and chronic endometrium in our study. Disordered proliferative endometrium was commonly observed in married females and those having duration of symptoms more than 6 months. Hyperplasia was more frequent in older patients who were married. Secretory phase was significantly more common in patients with prolonged disease and chronic endometritis was associated with marital status and prolonged disease duration.

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