Histopathological Interpretation of Abnormal Uterine Bleeding After the Age of 40 Year

Abstract

ABSTRACT:BACKGROUND:To delineat the frequancy and pattern of uterine lesions which result in abnormal uterine bleeding (AUB)after the age of 40 years.OBJECTIVE:To delineat the frequancy and pattern of uterine lesions which result in abnormal uterine bleeding (AUB after the age of 40 years) and to compare the result with other similar studiesMETHOD:Histopathological examination of the tissues obtained by curettage and/or hysterectomy play an important role in the diagnosis of the lesions which cause AUB..RESULTS:Organic intrauterine lesions was found in 69 (19%) of the cases. These included chronic endometritis (7.7%), endometrial polyp (6%), malignancy (3.9%) and submucous leiomyoma (1.4%) .On the other hand, the commonest histopathological finding in patient with AUB due to dysfunctional cause was endometrial hyperplasia which was found in (30.3%) of the cases, (27%) were simple endometrial type (cystic glandular hyperplasia).Postmenopausal bleeding is found in 76 cases (21%). Atrophic endometrium was the commonest finding of postmenopausal bleeding, which represented (34.2%). Endometrial adenocarcinoma was found in 3.3%.Eighty-two cases underwent hysterectomy after initial curetting due to persistent uterine bleeding, the endometrial lesions of (79) patients were confirmed at hysterectomy making the diagnostic accuracy of D and C(96.3%). Other uterine lesions were found at hysterectomy such as adenomyosis and leiomyoma.CONCLUSION:Dysfunctional uterine bleeding was the predominant cause of AUB in women above ( 40 ) years of age.