Oral Presentation

Hysteroscopic evaluation of abnormal uterine bleeding in postmenopausal women

Tatjana Jovanovic-Radisavljevic (RS), Sladjana Mihajlovic (RS), Dejan Filimonovic (RS), Snezana Rakic (RS), Nebojsa Zecevic (RS), Ana Mijailovic (RS), Sanja Novakovic (RS)

[Jovanovic-Radisavljevic] OB GYIN Clinic , [Mihajlovic] , [Filimonovic] , [Rakic] , [Zecevic] , [Mijailovic] , [Novakovic]

Introduction Abnormal uterine bleeding (AUB) describes all abnormal patterns of menstrual bleeding that may result from a wide variety of causes including anovulation, pregnancy, uterine pathology and coagulopathies. It is the single most common complaint that reproductive age females bring to their clinicians and it accounts for 33% of female patients referred to gynaecologists. In postmenopausal women, an evaluation should be preformed to exclude endometrial carcinoma, which is the cause in about 10% in population. Hysteroscopic evaluation in these patients gives a chance of direct visualisation of the cavity and guided biopsy of any local lesion, if present. Hysteroscopy, along with histological examination is now the golden standard for evaluation of abnormal uterine bleeding. Methods and materials We conducted a retrospective observational study, and included all postmenopausal women who were treated by hysteroscopic procedure, during the period from January the 1st until June the 1st 2017 year .Records were reviewed from paper charts and electronic medical records. From total of 89 postmenopausal women, we selected 63 patients who had abnormal uterine bleeding as the indication for hysteroscopy. We observed hysteroscopic and histipahtological findings, and results were statistically analized. Results The median age was 51 ± 4.84 years of age. The most common hysteroscopic findings were endometrial hyperplasia (42%), endometrial polyp (36%) and endometrial cancer (17%). Conclusion Hysteroscopy is the golden standard for evaluation of abnormal uterine bleeding since it provides excellent visualization of uterine cavity and target biopsy of alternated endometrium. It is of great importance, especially in postmenopausal women who are at higher risk of developing endometrial carcinoma. In addition, it is known that early diagnosis of endometrial cancer and adequate treatment offers a good prognosis.