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KMID : 1148020200450010023
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조선대학교의대논문집
2020 Volume.45 No. 1 p.23 ~ p.27
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The classification of postmenopausal uterine bleeding at the primary hospital
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Shim Da-Joung
Jung Hyuk
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Abstract
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Postmenopausal uterine bleeding is bleeding that occurs 12 or more months after the last menstrual period and accounts for 5% of all gynecologic office visits. While it is not always a symptom of cancer, the exclusion of endometrial hyperplasia and carcinoma is the key issue in the evaluation of patients with postmenopausal bleeding. The primary evaluation of postmenopausal women who present with abnormal uterine bleeding includes a medical history and a pelvic examination. Investigative studies, such as a endometrial biopsy, ultrasound, hysteroscopy or dilation and curettage, may be required. Treatment will depend on the cause determined. A retrospective analysis has been made of 36 cases of postmenopausal uterine bleeding. The women were at least 55 years old and the time lapse from the last menstruation was at least 12 month. The most usual endometrial lesions were endometrial polyp and atropic endometrium after vaginal sonography, hysteroscopy and endometrial biopsy in this study. There were all atrophic endometrium (100%) in case of below 4 mm of endometrial thickness, Above 4mm of endometrial thickness, endometrial polyp was most common (50%). And there was no endometrial cancer in this 36 cases study. The general consensus of opinion is that uterine bleeding occurring after the menopause must be considered as indicative of malignant disease, until it is proved to be otherwise. However, there is no universally accepted definition of postmenopausal uterine bleeding. And there may be statistical differences between primary hospital and tertiary hospital about cancer diagnosis frequency.
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KEYWORD
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Postmenopausal uterine bleeding, Atrophic endometrium, Polyp, Endometrial cancer
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