scholarly journals Ultrasound in screening of endometrial carcinoma in asymptomatic postmenopausal women

2009 ◽  
Vol 62 (5-6) ◽  
pp. 263-267 ◽  
Author(s):  
Aleksandar Curcic ◽  
Srdjan Djurdjevic ◽  
Ljiljana Mladenovic-Segedi ◽  
Zorica Grujic ◽  
Nemanja Visnjevac
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Ultrasound Examination ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Screening Method ◽  
Uterine Bleeding ◽  
Ultrasound Finding ◽  
Gynecological Examination ◽  
Significant Difference

Introduction The aim of this prospective study was to investigate whether there was a significant difference in ultrasound detection of pathologic states of endometrium between asymptomatic postmenopausal women and postmenopausal women with uterine bleeding in whom the thickness of endometrium was greater than 3 mm at ultrasound examination. Material and methods The study included 128 postmenopausal women with uterine bleeding and 29 asymptomatic posmenopausal women who underwent gynecological examination, transvaginal ultrasound examination, fractional explorative curettage and histopathological examination of the endometrium. Results The results showed no statistically significant difference between the examined groups of women in relation to the detection of pathologic states of the endometrium (polyps, hyperplasias and carcinomas) as well as between individual pathologic states, although the research showed that the asymptomatic women were more frequently presented with well-differentiated carcinoma versus the medium-differentiated carcinoma in the symptomatic group of women. Conclusion It can be concluded that the transvaginal ultrasound examination in postmenopausal women could be an adequate screening method for detection of endometrial carcinoma in early asymptomatic stage of the disease, whereas in the women with ultrasound finding of the thickened endometrium, the final diagnosis should be established by histopathological examination of the endometrium samples obtained by hysteroscopy, instead of previously used explorative curettage.

scholarly journals Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

2017 ◽  
Vol 6 (9) ◽  
pp. 4081
Author(s):  
Jiten Sharma ◽  
Bhishan Dhiman ◽  
Nishi Sud ◽  
Anupriya Kaushik
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Uterine Bleeding ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling ◽  
Combined Use ◽  
Vaginal Ultrasonography

Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.

scholarly journals Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy

2014 ◽  
Vol 12 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Marco Antonio Lenci ◽  
Vanessa Alessandra Lui do Nascimento ◽  
Ana Beatriz Grandini ◽  
Walid Makin Fahmy ◽  
Daniella de Batista Depes ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Premalignant Lesions ◽  
Endometrial Polyps ◽  
Menstrual Status ◽  
Cellular Atypia ◽  
Malignant Lesions

Objective : To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy. Methods : The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.9%) patients were in menacme. Of the total, 193 (65.4%) presented abnormal uterine bleeding, and 102 (34.6%) were asymptomatic with altered endometrial echo on transvaginal ultrasound. Out of 725 (71.1%) postmenopausal patients, 171 (23.6%) were symptomatic (abnormal uterine bleeding), and 554 (76.4%) were asymptomatic with endometrial echo >5.0mm. Results : Twenty-one (2.0%) patients presented premalignant lesions in the polyps, 13 had simple glandular hyperplasia, of which 5 had no atypia, and eight presented atypia. Eight polyps presented focal area of complex hyperplasia: 4 with atypia and 4 without lesions. Cancer was diagnosed in 5 (0.5%) polyps. Of the 21 polyps that harbored premalignant lesions, 12 were interpreted as benign in diagnostic and surgical hysteroscopy. Of the polyps with cancer, 4 were also histeroscopically interpreted as normal. Conclusion : Symptomatic polyps in menacme and in all postmenopausal women should be resected and submitted to histopathological examination, since they may have a benign aspect, even when harboring areas of cellular atypia or cancer.

Variation in Cervical Length over Time during a Single Transvaginal Ultrasound Examination

2018 ◽  
Vol 36 (08) ◽  
pp. 781-784
Author(s):  
Katherine A. Connolly ◽  
Luciana Vieira ◽  
Elizabeth M. Yoselevsky ◽  
Stephanie Pan ◽  
Joanne L. Stone
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Intraclass Correlation ◽  
Cervical Length ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Time Points ◽  
Significant Difference

Objective To quantify the degree of change in cervical length (CL) over a 3-minute transvaginal ultrasound. Study Design We conducted a prospective observational study of nulliparous patients who underwent routine transvaginal CL screening at the time of their second-trimester ultrasound. We recorded CL at four time points (0, 1, 2, 3 minutes) and compared these values to determine the minute-to-minute change within a single patient. Results A total of 771 patients were included. The mean gestational age was 20.8 weeks (±0.84). We used a linear mixed effect model to assess if each minute during the ultrasound is associated with a change in CL. The intraclass correlation coefficient between minute 0 to minute 3 was 0.82 (95% confidence interval: 0.80, 0.84). This indicates that there is a relatively high within-patient correlation in CL during their ultrasound. Additionally, we stratified patients based on their starting CL; the intraclass correlation coefficient remained high for all groups. We additionally compared CL at each minute. Although there is a statistically significant difference between several time points, the actual difference is small and not clinically meaningful. Conclusion The variation in CL over a 3-minute transvaginal ultrasound examination is not clinically significant. It may be reasonable to conduct this examination over a shorter period.

scholarly journals Histo-Pathological Study of Endometrial Biopsies in Patients With Abnormal Uterine Bleeding

2017 ◽  
Vol 15 (2) ◽  
pp. 26-31
Author(s):  
Sharmila Parajuli ◽  
Binita Thapa
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Common Cause ◽  
Histopathological Findings ◽  
Common Sign ◽  
Work Up

Introduction: Abnormal uterine bleeding is a common sign of a number of different uterine disorders ranging from dysfunctional (non organic) abnormalities or complications of pregnancy to organic lesions such as polyps, hyperplasia or carcinoma. Methods: This is a retrospective study conducted at Hospital of 2nd author during a period of 5 years (Jan 2008-Dec 2013).  Histopathology records were retrieved and searched for cases of abnormal uterine bleeding. Relevant histopathological findings and clinical data were recorded and analyzed. The aim of the study was to determine the causes for abnormal uterine bleeding in women presenting to the hospital and to compare the histopathological findings at various age groups.Results: The age of patients ranged from 17 to 71 years with an average of 43 years. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.43%). Out of the pathological causes, the most common cause was found to be endometrial hyperplasia- 44 cases (3.82%). Endometrial carcinoma was found to be more common in the elderly postmenopausal women. A total of 6 cases (0.5%) of endometrial carcinoma were present.Conclusion: Endometrial hyperplasias and malignancies are common in increasing age group, especially in perimenopausal and postmenopausal women. So, a thorough work-up and diagnostic endometrial biopsy is therefore mandatory without delay in these patients to rule out malignancies. 

Comparison of Uterine Artery Blood Flow Parameters in Women with Dysfunctional Uterine Bleeding, Fibroids and Healthy Controls

BMUS Bulletin ◽  
1997 ◽  
Vol 5 (2) ◽  
pp. 25-26 ◽  
Author(s):  
Kalpani P Lakhani ◽  
Paul Hardiman
Keyword(s):  
Blood Flow ◽  
Vascular Resistance ◽  
Ultrasound Examination ◽  
Resistance Index ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Prospective Clinical Study ◽  
Healthy Controls ◽  
Dysfunctional Uterine Bleeding ◽  
Significant Difference

Objective To assess uterine vascular resistance in women with dysfunctional uterine bleeding (DUB) and to compare parameters of blood flow in women with menorrhagia due to uterine fibroids and healthy controls Design Longitudinal, prospective clinical study. Materials and methods Premenopausal women referred to the gynaecology department with a subjective complaint of menorrhagia. The subjects were 24 women with DUB (mean age 38.8 years; normal ultrasound, hysteroscopy and endometrial biopsy), 16 women (mean age 42.8 years) with at least one fibroid greater than 2.0cm on ultrasound examination and 18 healthy controls (mean age 37.3 years; no evidence of menstrual irregularity). None was taking any hormonal contraception or other medication which could influence vascular resistance. Ultrasound examination was performed using an ALOKA SSD 650 with a 5MHz transvaginal probe. Scans were performed on day 4 or 5 of menstrual cycle using pulsed Doppler ultrasound. Uterine vascular resistance was assessed on both sides using pulsatility index (PI) and resistance index (RI). Results No significant difference in the PI or RI values was observed in women with DUB as compared to age matched healthy controls. Both PI and RI were significantly lower in women with menorrhagia associated with fibroids when compared with healthy controls. Conclusions The results of this study demonstrated significant alteration in uterine vascular resistance in women with fibroids compared to women with DUB.

scholarly journals Topical estradiol does not interfere with the expression of the metalloproteinase-1 enzyme in photo exposed skin cells

2012 ◽  
Vol 87 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Luciana Neder ◽  
Sebastião Freitas de Medeiros
Keyword(s):  
Postmenopausal Women ◽  
Pap Smear ◽  
Transvaginal Ultrasound ◽  
Hormone Replacement ◽  
Exposed Skin ◽  
Significant Difference ◽  
Before And After ◽  
Dermal Collagen ◽  
Cutaneous Atrophy ◽  
The Right

BACKGROUND: In postmenopausal women there is a rapid destruction of dermal collagen, resulting in accelerated skin ageing, which is manifested by cutaneous atrophy, increased number and depth of wrinkles and sagging. This accelerated catabolism of the collagen is due to estrogen deficiency and increased synthesis of the metalloproteinase-1 enzyme, which degrades the dermal collagen. OBJECTIVES: To assess whether the use of topical estradiol 0.05% cream on photo exposed skin can inhibit the expression of the metalloproteinase-1 enzyme on the dermis and subsequently the rapid loss of collagen in women after menopause. METHODS: We included 40 postmenopausal women without hormone replacement therapy. Information about lifestyle, lipid profile, blood glucose level, thyroid hormones, mammography, Pap smear and transvaginal ultrasound were obtained to rule out associated diseases. Skin biopsy of the right preauricular region was performed before and after treatment with topical estradiol 0.05% for 30 days. The biopsy specimens were subjected to immunohistochemistry to identify the expression of the metalloproteinase-1 enzyme. RESULTS: There was no statistically significant difference on the expression of the metalloproteinase-1 enzyme in keratinocytes, fibroblasts and endothelial cells before and after treatment with topical estradiol for 30 days. CONCLUSION: Treatment with estradiol 0.05% cream, in photo exposed skin for 30 days, does not inhibit the production of metalloproteinase-1.

scholarly journals Uterus Didelphys dengan Agenesis Servik Bilateral

2020 ◽  
Vol 4 (1) ◽  
pp. 133-138
Author(s):  
Dwinda Rizary ◽  
Dedy Hendry
Keyword(s):  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Primary Amenorrhea ◽  
Female Reproductive System ◽  
Uterus Didelphys ◽  
Sex Development ◽  
Normal Limits ◽  
Gynecological Examination ◽  
Future Fertility ◽  
Uterine Adenomyosis

Background : The mullerian duct anomaly is a congenital abnormality of the female reproductive system caused by abnormal embryological development during pregnancy. If accompanied by cervical agenesis and infertility, intervention must be taken. Accurate diagnosis and proper treatment are very crucial to the future of reproduction and treatment of infertility in patients.Objective: Reporting the handling of cases of uterine didelphys accompanied by bilateral cervical agenesis.Method : Case reportCase: Reported cases of women aged 34 years with primary amenorrhea and 9 years primary infertility, not typical cyclic pain, normal secondary sex development and from gynecological examination obtained cervical agenesis. Transvaginal ultrasound examination found a mass with the appearance of adenomyosis. Laparoscopic performed show 2 masses, 1 mass resembling adenomyosis with a size of 9x6x5cm located lateral to the left pelvis and another mass in the form of a hypoplastic uterus with a size of 2x2x1cm visible 2 tubes with 2 ovaries within normal limits. Uterine mass resembling adenomyosis with a location far from the vagina making it difficult to do anastomoses while other uterus hypoplasia and non-functional. Hysterectomies were performed on the mass of adenomyosis with the results of PA was adenomyosis.Conclusion: The uterus didelphys with bilateral cervical agenesis with 1 uterine adenomyosis and located in the pelvic lateral it was difficult to do uterovaginal anastomose so that hysterectomy was performed. Second uterine was hypoplasia and non-functional so that no action was taken. Need to think about "future fertility" in these patients and various options for having children. Keywords: Primary Amenorrhea, Uterine Didelphys, Cervical Agenesis, Adenomyosis

scholarly journals Ultrasound detection of endometrial fluid in postmenopausal women

2009 ◽  
Vol 62 (7-8) ◽  
pp. 337-341 ◽  
Author(s):  
Aleksandar Curcic ◽  
Srdjan Djurdjevic ◽  
Slobodana Mihaldzic-Tubic ◽  
Ljiljana Mladenovic-Segedi ◽  
Marko Maksimovic
Keyword(s):  
Postmenopausal Women ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Fluid Collection ◽  
Uterine Bleeding ◽  
Pathological Changes ◽  
Asymptomatic Group ◽  
Ultrasound Investigation ◽  
Asymptomatic Women ◽  
Histopathological Investigation

Introduction. The aim of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women. Material and methods. 128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens. Results. There were significantly more asymptomatic women with endometrial fluid collection was found (41,4%) than those with uterine bleeding (7,8%) (p<0,001). We found 4 cases of carcinoma of the endometrium, 4 with hyperplasia and 1 with polyp of the endometrium in women with uterine bleeding and endometrial fluid collection. In the asymptomatic group of women we found 1 case with polyp and 1 with carcinoma of the endometrium. In the presence of endometrial fluid collection the least thickness of the endometrium measured by transvaginal ultrasound was 12 mm in postmenopausal women with carcinoma of the endometrium, 7 mm in women with hyperplasia and 5 mm with polyp. No pathological changes were found below the above values. Conclusion. The presence of endometrial fluid detected by transvaginal ultrasonography is a good marker for pathological changes of the endometrium in postmenopausal women if the endometrial thickness is greater than 4 mm. If the endometrial thickness is 4 mm or less, the presence of endometrial fluid is not an indication for further invasive investigation of endometrial cavity, but we must eliminate possible presence of ednexal or cervical malignant disease in some patients.

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.

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