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Introduction:Abnormal uterine bleeding (AUB) is considered one of the most common and challenging problems presenting to the gynecologist. Histopathological examination of endometrial biopsy is gold standard diagnostic tool in evaluation of AUB. Our study is aimed at determining the spectrum of endometrial pathologies in different age group patients presenting with AUB at our hospital which caters largely to women living in rural area. Materials & Methods : The present study is a retrospective and prospective study done for a period of one year in department of Pathology. All hysterectomy cases and endometrial biopsy cases were considered in the present study. Complete patient history, clinical and radiological findings were considered. Results: A total of 100 cases were included in our study and out of them the most common lesion was proliferative phase constituting upto 33 cases followed by secretory phase.The most common age group was in between 31-40 years. The most common complaint was abnormal uterine bleeding. Conclusion: Histopathological examination of endometrium is gold standard diagnostic tool in evaluation of AUB and there is an age specific association of endometrial lesions.
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Background: Menstrual disorders are the second most common gynecological condition resulting in hospital referrals. Dysfunctional Uterine Bleeding is defined as abnormal uterine bleeding in the absence of organic disease. Menorrhagia (menstrual blood loss >80 ml per cycle) affects 10-33% of women at some stage in their lives. Approximately 90% of dysfunctional uterine bleeding result from anovulation and 10% occur with ovulatory cycles. Only half of women complaining of heavy menstrual bleeding fit the clinical criteria of more than 80 ml blood loss per cycle. Among women aged 30-49, one in 20 consults her general practitioner each year with menorrhagia . it can be managed both medically and surgically. Material and methods: Thirty women presenting with DUB were randomly allocated to 2 equal groups, Group-A, which received 60 mg ormeloxifene twice a week for 12 weeks and Group-B, which received 5 mg norethisteron twice daily for 21 days for 3 months. The primary outcome measures were reduction in menstrual blood loss which was measured by fall in PBAC (Pictorial Blood loss Assessment Chart) score, rise in hemoglobin level and reduction in endometrial thickness Results: The reduction in mean PBAC score with ormeloxifene (277.33 to 70.11) was significantly more than that seen with norethisterone (246 to 108.5) after 3 months of therapy (p<0.05). The increase in hemoglobin level and reduction in endometrial thickness were also found to be significantly more with ormeloxifene than norethisterone (9.68 g %to 11.07 g% vs. 10.17 g% to 10.58 g%, p<0.05, and 7.8 mm vs. 6.7 mm to 5.9 mm, p<0.05, respectively). No major side effects were reported in any group. Conclusion: Ormeloxifene was found to be more effective than norethisterone in reducing blood loss and reducing endometrial thickness
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Uterine balloon therapy is a minimally invasive technique for dysfunctional uterine bleeding done on day care basis. It can be offered as a treatment of option to women who have completed their family and have a diagnosis of dysfunctional uterine bleeding. The study was undertaken to analyse the success rate, complications of UBT and incidence of patients requiring alternative methods of treatment for DUB. Twenty four patients were treated with UBT (Thermachoice) for DUB. Efficacy of the procedure was analyzed at follow up periods of one, 3, 6 and 12 months. After undergoing UBT, at twelve months follow up, amenorrhea was achieved in 29.17% of patients, 33.33% were having oligomennorhea, 33.33% were eumenorrehic and no response was seen in 4.17% of patients. Our overall treatment success and patient satisfaction rate was 95.83%.Uterine balloon therapy is a safe, minimally invasive day care procedure requiring no extra expertise for the treatment of DUB in patients who want to save uterus with instant results. Post procedure there is improved patient well being and high treatment satisfaction.
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OBJECTIVES: Dysfunctional uterine bleeding(DUB) is defined as abnormal bleeding from the uterine endometrium unrelated to anatomic lesions of the uterus, and its incidence is 10-15% among gynecologic diseases. We conducted this study for understanding correlation between clinical aspecets and pathological findings of DUB. Methods: We conducted a retrospective review of 599 women with DUB who underwent endometrial biopsy with special regard to the relation between pathologic findings and presenting symtoms or complaints from Jan. 1988 to Dec. 1997. RESULTS: Age distribution of DUB was mainly 5th decade, mean age was 44.1years, among various bleeding patterns, intermenstrual bleeding was the most common pattern(31.6%) and the next was menorrhagia(25.0%). Histologic findings of endometrium were proliferative phase, 327 cases(54.6%), hyperplasia, 139 cases(23.2%), secretory phase, 74 cases(12.4%) in order of frequency, and there was no difference in distribution of histologic findings among various bleeding patterns. CONCLUSION: Compared to other previoius studies, our study showed more incidence of endometrial hyperplasia, especially at age group of 40 or more. So patients aged more than this age with abnormal uterine bleeding must undergo emdometrial biopsy for pathologic diagnosis. Patients who are diagnosed endometrial hyperplasia must be carefully followed up because there are possibilities of progression to endometrial carcinoma.