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Objective: To investigate the clinical significance of postmenopausal bleeding in terms of risk factors, incidence of endometrial carcinoma and histopathological evaluation of endometrium.
Material and Methods: This descriptive study was carried out in Obstetrics and Gynaecology Unit “C”, Khyber Teaching Hospital, Peshawar, from January 2012 to February 2014. A total of 36 patients with postmenopausal bleeding were enrolled in the study (aged 49-78 years). These patients were evaluated by transvaginal ultrasonography, diagnostic curettage and endometrial biopsy followed by histological assessment of the endometrium.
Results: On histological analysis, malignancy was found in 33.3% cases. The most common malignancy was endometrial
carcinoma (30.55%), while one case of cervical carcinoma (2.8%) was detected. Pre-malignant lesions (atypical endometrial hyperplasia) were found in 14% cases. Benign causes were responsible for 52.8% cases of postmenopausal bleeding, among them atrophic endometrium was the most common finding (36.8%), followed by chronic endometritis (31.6%) and benign endometrial polyps (26.3%). Furthermore, obesity (72.7%), diabetes mellitus (54.5%) and hypertension
(27.3%) were frequently observed in patients with endometrial carcinoma.
Conclusion: Postmenopausal bleeding is an alarming symptom and therefore, further investigation is mandatory in order to detect endometrial cancer at an early stage and affect a cure.
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