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. 2022 Mar 6;10(7):2159-2165.
doi: 10.12998/wjcc.v10.i7.2159.

Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium

Hui Xue  1 , Wen-Jing Shen  1 , Yi Zhang  2
Affiliations

Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium

Hui Xue et al. World J Clin Cases. .

Abstract

Background: Postmenopausal bleeding and an endometrial thickness ≥ 5 mm on sonograms of menopausal women can indicate the presence of endometrial lesions. Diagnostic hysteroscopy is a powerful method for endometrial diseases.

Aim: To investigate the pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or asymptomatic thickened endometrium diagnosed by hysteroscopy.

Methods: A total of 187 postmenopausal women with bleeding or asymptomatic thickened endometrium underwent diagnostic hysteroscopy. The women were subsequently divided into three groups: Postmenopausal bleeding (PMB) group (n = 84), asymptomatic group (n = 94), and additional group (n = 9). Women in the additional group manifested abdominal pain and leukorrhagia.

Results: Among the 187 patients examined, 84 (44.9%) were diagnosed with PMB and 94 (50.3%) with asymptomatic thickened endometrium. Endometrial polyp was the most common endometrial abnormality, which was detected in 51.2%, 76.6% and 77.8% of the PMB, asymptomatic, and additional groups, respectively. In the PMB group, 7 (8.3%) women had hyperplasia with atypia and 14 (16.7%) had endometrial adenocarcinoma. Fewer malignant lesions were detected in the asymptomatic group. Endometrial hyperplasia without atypia was found in 8.3% of the PMB group and 7.4% of the asymptomatic group.

Conclusion: Endometrial polyp was the most common pathology in the PMB group. Diagnostic hysteroscopy is recommended for women with PMB and asymptomatic thickened endometrium.

Keywords: Adenocarcinoma; Endometrium; Hysteroscopy; Polyps; Postmenopause.

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Conflict of interest statement

Conflict-of-interest statement: There are no conflicts of interest to report.

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