Publication:

Clinicopathological evaluation of postmenopausal bleeding in rural hospital set up

Background Postmenopausal bleeding should be completely assessed to ensure the absence of malignancy and to identify and treat high risk patients such as those with endometrial hyperplasia. The aim of present study was to investigate the clinical significance and endometrial pathology in patients with postmenopausal bleeding.

Methods A cross sectional study was carried on 100 patients with postmenopausal bleeding visiting Acharya Vinobha Bhave rural hospital, Sawangi between August 2009-December 2011. Patients were evaluated according to pelvic ultrasound, fractional curettage and endometrial histology.

Results The incidence of postmenopausal bleeding was maximum between 51-60 years (48%), the incidence of malignancy was 39%, out of which carcinoma cervix was the commonest. In benign causes, dysfunctional uterine bleeding and prolapse with decubitus ulcer were the commonest. The histopathological evaluation suggested proliferative endometrium (25.64%), atrophic endometrium (34.61%) atypical endometrium (7.69%) adenocarcinoma (7%). On ultrasound, commonest finding was increased endometrial thickness >4 mm.

Conclusions Carcinoma of genital tract is one of the important cause of postmenopausal bleeding, so early detection of the causes can be life-saving. Fractional curettage gives a better diagnosis of the causes of postmenopausal bleeding.