scholarly journals Hysteroscopy in one hundred cases of postmenopausal uterine bleeding, in the detection of uterine cancer and atypical endometrial hyperplasia

2020 ◽  
Vol 9 (6) ◽  
pp. 2253
Author(s):  
Pratibha Devabhaktuni ◽  
Padmaja Allani ◽  
Suneetha Komatlapalli ◽  
Rekha Rani Ksheerasagara
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Uterine Cancer ◽  
Endometrial Adenocarcinoma ◽  
Atypical Hyperplasia ◽  
Postmenopausal Bleeding ◽  
Uterine Carcinosarcoma ◽  
Benign Lesions ◽  
Operative Hysteroscopy ◽  
Vaginal Sonography

Background: Evaluation was done in 100 women presenting with postmenopausal bleeding, (PMB), to discuss the utility of hysteroscopy combined guided endometrial curettage in the diagnosis of uterine cancer and endometrial hyperplasia, and, treat benign lesions, like polyps, synechiae at the same sitting. At MGMH during the years, 2002 to 2006, there were 57 women, and at care, 40 women with PMB during 2011 to 2013, and three in a nursing home, Hyderabad, were investigated.Methods: Evaluation was done in 100 women presenting with PMB by hysteroscopy and curettage to diagnose the cause of PMB and benign lesions like polyps, synechiae were managed by operative hysteroscopy. Bettocchi 5 mm hysteroscope, monopolar instruments and glycine was used for excision of polyps.Results: In one hundred women with PMB, 19% had cancer. Endometrial adenocarcinoma in 14, endocervical carcinoma in 2, uterine carcinosarcoma in 3 cases. All 3 cases of uterine carcinosarcoma on hysteroscopy were large polyps measuring 5×5-6 cm size. Atypical hyperplasia endometrium in 7% and simple hyperplasia in 17%, was reported on histopathology, in cases with hyperplastic endometrium on hysteroscopy. Benign polyps in 41% were managed at the same sitting by operative hysteroscopy.Conclusions: Women with postmenopausal bleeding must have USG, trans vaginal sonography (TVS), endometrial thickness (ET) measurement, preferably endometrial echo complex (EEC). In women with PMB, the risk of uterine cancer would be 19%, i.e., 1 out of 5 women. Atypical hyperplasia in 7%. Hysteroscopy guided curettage, with histopathology, is the gold standard protocol in cases of PMB.

scholarly journals Clinical study of risk factors and ultrasonographic correlation of endometrial hyperplasia according to the WHO classification 2014

2020 ◽  
Vol 9 (12) ◽  
pp. 4989
Author(s):  
Janu Mangala Kanthi ◽  
Sudha Sumathy ◽  
Anu Vasudevan ◽  
Gokulkumar Kamalanathandurai
Keyword(s):  
Risk Factors ◽  
Endometrial Hyperplasia ◽  
Who Classification ◽  
Endometrial Thickness ◽  
Color Doppler ◽  
Significant Risk ◽  
Atypical Hyperplasia ◽  
Obese Women ◽  
Obesity And Diabetes ◽  
Significant Difference

Background: Type 1 endometrial carcinoma is usually preceded by atypical hyperplasia. Nonatypical hyperplasia should be managed conservatively and atypical hyperplasia have to be managed aggressively. So, the diagnosis is crucial for its management.Methods: The study population included women diagnosed with endometrial hyperplasia by histopathology as per WHO classification 2014 from the year January 2015 to February 2020.Women with endometrial polyp diagnosed by transvaginal ultrasonography and histopathology were excluded. Primary objective was to compare the endometrial thickness between the two types of hyperplasia. Secondary objective was to analyses the risk factors of the two types.Results: In multivariate analysis of logistic regression, diabetic women have 1.57 times risk of developing atypia and obese women have 3.12 times risk of developing atypia. Polycystic ovarian disease is having borderline significance for causing atypia. There was significant difference in endometrial thickness between atypical and nonatypical hyperplasia (P=0.040). In premenopausal women, (P=0.069) the thickness difference in atypia is of only borderline significance. Heteroechoic pattern or cystic spaces in the endometrium also didn’t predict atypia.Conclusions: Mean endometrial thickness is significantly different in atypical hyperplasia. Heteroechoic pattern of endometrium do not predict atypia. We need color doppler sonography to gain knowledge about atypia. Obesity and diabetes mellitus are significant risk factors of atypia.

Fertility-Sparing Treatment of Early Endometrial Cancer and Complex Atypical Hyperplasia in Young Women of Childbearing Potential

2015 ◽  
Vol 25 (6) ◽  
pp. 1010-1014 ◽  
Author(s):  
Stanislav Mikhailovich Pronin ◽  
Olga Valerievna Novikova ◽  
Julia Yurievna Andreeva ◽  
Elena Grigorievna Novikova
Keyword(s):  
Endometrial Cancer ◽  
Young Women ◽  
Hormonal Therapy ◽  
Endometrial Hyperplasia ◽  
Endometrial Adenocarcinoma ◽  
Gonadotropin Releasing Hormone ◽  
Atypical Hyperplasia ◽  
Childbearing Potential ◽  
Atypical Endometrial Hyperplasia ◽  
Gonadotropin Releasing Hormone Agonist

ObjectiveTo evaluate oncologic and reproductive outcome with levonorgestrel-releasing intrauterine system combined with gonadotropin-releasing hormone agonist in women with grade 1 endometrial carcinoma, and the levonorgestrel monotherapy in women with complex atypical hyperplasia.Materials/MethodsA prospective study was conducted. We analyzed the clinical characteristics of 70 patients younger than 42 years (mean age, 33 years) with a diagnosis of complex atypical endometrial hyperplasia (AEH) or grade 1 endometrial adenocarcinoma who were treated with hormonal therapy at the Division of Gynecologic Oncology of P.A. Hertsen Moscow Cancer Research Institute from February 2009 to December 2012. Patients with complex AEH received monotherapy with levonorgestrel-releasing intrauterine system (Mirena, Shering, Finland; 52 mg). Patients with a diagnosis of grade 1 endometrial cancer were treated with levonorgestrel-releasing intrauterine system combined with gonadotropin-releasing hormone agonist (Zoladex; AstraZeneca UK Limited, UK; 3.6-mg depot). All the patients received hormonal therapy for a minimum of 6 months. Pretreatment evaluation consisted of transabdominal and transvaginal ultrasound in grayscale, color Doppler ultrasound, contrast-enhanced magnetic resonance imaging,cervical hysteroscopy, Pipelle endometrial biopsy, and morphological and immunohistochemical characteristics of the tissue.ResultsSeventy patients were included in study analyses. Twenty three (72%) of 32 patients with adenocarcinoma and 35 (92%) of 38 patients with AEH had complete remission, defined as the absence of any carcinoma or hyperplasia on endometrial sampling specimens. Among these cases, 2 patients with adenocarcinoma and 1 patient with AEH had recurrence after their complete response. Nine patients had persistent disease. Eight patients had 10 conceptions, resulting in 8 live births.ConclusionsThe suggested conservative treatment strategy can be considered as a valid therapeutic option for young women of childbearing potential with atypical endometrial hyperplasia and grade 1 endometrial adenocarcinoma who wish to preserve their fertility and thus may be recommended as an alternative to hysterectomy. Close follow-up during and after the treatment period is strictly required.

scholarly journals Hysteroscopy: an effective tool in post-menopausal bleeding

2018 ◽  
Vol 8 (1) ◽  
pp. 159
Author(s):  
K. K. Junnare ◽  
G. J. Desai ◽  
G. S. Shekhawat
Keyword(s):  
Vaginal Bleeding ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Transvaginal Sonography ◽  
Postmenopausal Bleeding ◽  
Diagnostic Modalities ◽  
Post Menopausal ◽  
Histopathology Examination ◽  
Endometrial Pathology ◽  
Vaginal Ultrasonography

Background: Postmenopausal bleeding is a condition where endometrial carcinoma is to be ruled out. Traditionally, D and C is the preferred method for diagnosis in such condition. Other diagnostic modalities like trans vaginal ultrasonography (TVS) and hysteroscopy are being used for diagnosis in the cases of PMB. The objective of this study is to evaluate the efficacy and accuracy of TVS and hysteroscopy in women with postmenopausal bleeding (PMB).Methods: One hundred postmenopausal women with vaginal bleeding underwent TVS and hysteroscopy. Endometrial tissue was obtained by curettage and sent for histopathology examination. The results of TVS and Hysteroscopy were compared against HP report.Results: Hysteroscopy was successful in 98 patients. Endometrial histopathology revealed proliferative, secretory and atrophic endometrium in 26, 7 and 23 patients respectively. Polyp was diagnosed in 13 patients. Endometrial hyperplasia was detected in 11 patients and endometrial malignancy in 14 patients. All patients with endometrial hyperplasia and malignancy had ET (endometrial thickness) more than 4 mm, except one patient with endometrial malignancy who had 4 mm ET. The sensitivity and specificity of TVS for suspecting endometrial pathology at ET 4mm were 93% and 69.6%, respectively. Hysteroscopy had sensitivity of 95.2%, specificity of 92.8%, with diagnostic accuracy of 93.8%.Conclusions: Hysteroscopy was found to be the more sensitive and specific than Transvaginal sonography for diagnosing endometrial pathologies. Hysteroscopy is safe and effective for detecting endometrial pathologies in patients with PMB.

scholarly journals Study of endometrium by trans-vaginal sonography and it’s correlation with histopathology in perimenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (9) ◽  
pp. 3554
Author(s):  
Vandana R. Saravade ◽  
Shuchi Chaturvedi
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Dilation And Curettage ◽  
Perimenopausal Women ◽  
Multiparous Women ◽  
Vaginal Sonography

Background: Objectives of the study were to study the endometrial patterns in cases of abnormal uterine bleeding (AUB) and anatomical (structural) lesions of uterus using transvaginal sonography (TVS) and endometrial histopathology and to determine the efficacy of TVS.Methods: Cross-section study of 50 perimenopausal age group with AUB in TNMC BYL Nair hospital from Nov 2017 to Nov 2018.Results: AUB was seen 40 to 45 years multiparous women TVS endometrial thickness (ET) T 6-10 mm (46%), ET 11-15 (22%), ET>15 mm (14%), <5 mm in (18%), showed 21 (42%) patients with endometrial hyperplasia on TVS, 12 (24%) simple hyperplasia 4 (8%) complex hyperplasia on histopathology fibroid 8%, adenomyosis 2%. endometrial polyp 6%.Conclusions: Endometrial lining exceeds 10 mm dilation and curettage to be done r/o endometrial hyperplasia, to study the endometrial patterns in cases of abnormal uterine bleeding and anatomical (structural) lesions of uterus using transvaginal sonography and endometrial histopathology.

scholarly journals Hysteroscopy—A Mode of Screening Women with Postmenopausal Bleeding: Our Experience

2011 ◽  
Vol 3 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Sejal Naik ◽  
Pooja Lodha ◽  
Sunita Tandulwadkar ◽  
Bhavana Agarwal ◽  
Prashant Deshmukh
Keyword(s):  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Postmenopausal Bleeding ◽  
Benign Lesions ◽  
Study Objective ◽  
Sonographic Evaluation ◽  
Precise Diagnosis ◽  
Histopathological Results

ABSTRACT Study Objective 1. To study the etiology of postmenopausal bleeding. 2. To study the significance of hysteroscopy in evaluation of the etiopathogenic factors. 3. Correlating the diagnosis after transvaginal sonography (TVS), hysteroscopy and histopathology. 4. Feasibility of conservative management with hysteroscopy in postmenopausal bleeding. Design Prospective study from January 2009 to June 2010. Setting Department of Obstetrics and Gynecology of Ruby Hall Clinic, Pune, Maharashtra, India. Sample size Sixty postmenopausal women with complaint of bleeding per vaginum. Interventions Clinical and sonographic evaluation followed by diagnostic and/or therapeutic hysteroscopy and guided biopsy. Hysteroscopic images were analyzed and compared with histopathological results. Measurements and main results On hysteroscopy, endometrium is classified as suggestive of normal, atrophic, endometrial hyperplasia or endometrial carcinoma. Histopathological diagnosis was taken as a gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. The sensitivity and specificity of hysteroscopy in diagnosing endometrial pathologies was assessed. Conclusions In women with postmenopausal bleeding, hysteroscopy is a valuable tool that allows precise diagnosis of various endouterine pathologies. In our study, the sensitivity of hysteroscopy was 97% and the specificity was 98.66%. Hence, we can conclude that it is highly accurate for evaluating endometrial pathologies. For obvious benign lesions, it also provides treatment in the same sitting, therefore avoiding an extensive, morbid, and expensive procedure like hysterectomy.

A STUDY OF ENDOMETRIAL THICKNESS IN TRANS VAGINAL SONOGRAPHY IN RELATION WITH HISTOPATHOLOGY REPORT IN DILATION & CURRATAGE IN AUB WOMEN

2019 ◽  
pp. 1-2
Keyword(s):  
Comparative Study ◽  
Endometrial Thickness ◽  
P Value ◽  
First Line ◽  
Non Invasive ◽  
Dilation And Curettage ◽  
Study Results ◽  
Vaginal Sonography ◽  
In Trans

A study of of endometrial thickness on TVS in relation with histopathology report on dilation and curettage. AIM AND OBJECTIVE-To set a cut off limit of endometrial thickness on TVS for differtiating between normal and abnormal endometrium. MATERIAL AND METHOD-hospital based comparative study. RESULTS-TVS is non invasive ,simple first line procedure in AUB women. Mean endometrial thickness in normal endometrial group was 8.00±2.44 mm and in abnormal endometrial group was 15.16±33 mm.The difference was found highly significant (p value<.001)

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.</p><p><strong>Study Design:</strong> This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient group</p><p><strong>Conclusion:</strong> Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.</p>

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