EVALUATION OF HYSTEROSCOPIC AND PATHOLOGICAL FINDINGS IN WOMEN WITH ABNORMAL UTERINE BLEEDING

Yıl 2024, Cilt: 10 Sayı: 1, 277 - 288, 15.05.2024

Ufuk Atlıhan , Eyuphan Ozgozen , Begüm Ertan

Öz

Introduction: Although abnormal uterine bleeding (AUB) is generally a symptom of benign pathologies. It may also be the most common symptom of endometrial hyperplasia (EH) or cancer. Hysteroscopy (H/S) has great diagnostic accuracy because it allows direct visualization of these pathologies. In our study, we aimed to evaluate the hysteroscopic findings and histopathological results of women with abnormal uterine bleeding who underwent hysteroscopy and biopsy. Materials and Methods: From our study, 2440 patients who were admitted to our hospital between January 2018-2023 and were diagnosed with AUB were evaluated retrospectively. Demographic characteristics of the patients were obtained from the hospital database. H/S were preferably performed in the early follicular phase of the menstrual cycle when there was no or very little bleeding. Results: When the findings obtained before confirming the histopathological diagnosis in patients who underwent hysteroscopy because of AUB were evaluated, no intrauterine pathology was observed in 1320 (54%) patients. Endometrial polyp was detected in 890 (36.4%) patients in the study group and was noted as the most frequently reported hysteroscopic finding. Leiomyoma in 115 (5.1%) patients, EH in 70(2.8%) patients, intrauterine device (IUD) loss in 25 (1%) patients, intrauterine adhesion in 15 (0.6%) patients, and Endometrial Cancer was detected in 5 (%0.2) patients. When the histopathological results were evaluated in patients who underwent hysteroscopy because of AUB, no intrauterine pathology was observed in 1390 (56.9%) patients. Endometrial polyp was detected in 830 (34%) patients and was noted as the most frequently reported histopathological finding. In the study group, 110 (4.5%) patients had leiomyoma, 65 (2.6%) had EH, 25 (1%) had IUD loss, 15 (0.6%) had intrauterine adhesion, 5 (0.2%) patients had Endometrial Cancer. Conclusion: For a general evaluation, H/S is an important tool in premenopausal women. Hysteroscopic findings and histopathological diagnoses may show a good correlation in experienced hands.

Anahtar Kelimeler

Abnormal Uterin Bleeding, Curettage, Hysterescopy

Anormal Uterin Kanama Olan Kadınlarda Histeroskopik ve Patolojik Bulguların Değerlendirilmesi

Öz

Giriş: Anormal uterin kanama (AUK) genellikle iyi huylu patolojilerin belirtisi olmakla birlikte endometriyal hiperplazi veya kanserlerin de en sık görülen semptomu olarak karşımıza çıkabilir. Histeroskopi bu patolojilerin doğrudan görüntülenmesine olanak sağladığından büyük bir teşhis doğruluğuna sahiptir. Çalışmamızda, Anormal uterin kanaması olup histeroskopi ve biyopsi yapılan kadınların histeroskopik bulgularını ve histopatolojik sonuçlarının değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamızdan Ocak 2018-2023 tarihlerin arasından hastanemize başvuranı ve anormali uterin kanama tanısı koyulanı 2440 hasta retrospektif olarak değerlendirilmiştir. Hastaların demografik özellikleri hastane veritabanından elde edilmiştir. Histeroskopiler tercihen adet döngüsünün erken foliküler fazında kanamanın olmadığı veya çok az kanamanın olduğu dönemde gerçekleştirildi. Bulgular: AUK nedeniyle histereskopi yapılan hastalarda histopatolojik tanı doğrulanmadan önce elde edilen bulgular değerlendirildiğinde 1320(%54) hastada herhangi bir intrauterin patoloji görülmedi. Çalışma grubundaki 890(%36,4) hastada Endometrial polip saptanmış olup, en sık bildirilen histeroskopik bulgu olarak not edilmiştir. 115(%5,1) hastada leiomyom, 70(%2,8) hastada endometriyal hiperplazi, 25(%1) hastada intrauterin araç (RİA) kaybı, 15(%0,6) hastada intrauterin adezyon, 5(%0,2) hastada endometrium kanseri saptanmıştır. AUK nedeniyle histeroskopi yapılan hastalarda histopatolojik olarak elde edilen sonuçlar değerlendirildiğinde 1390(%56,9) hastada herhangi bir intrauterin patoloji görülmedi. 830(%34) hastada Endometrial polip saptanmış olup, en sık bildirilen histopatolojik bulgu olarak not edilmiştir. Çalışma grubundaki 110(%4,5) hastada leiomyom, 65(%2,6) hastada endometriyal hiperplazi, 25(%1) hastada intrauterin araç kaybı, 15(%0,6) hastada intrauterin adezyon, 5 (%0,2) hastada endometrium kanseri vakası saptanmıştır. Sonuç: Genel bir değerlendirme için histeroskopi premenopozal kadınlarda önemli bir araçtır. Histeroskopik bulgular ve histopatolojik tanılar deneyimli ellerde iyi bir korelasyon gösterebilir.

Anahtar Kelimeler

Anormal Uterin Kanama, histereskopi, küretaj

Kaynakça

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