Recurrent postmenopausal bleeding: a prospective cohort study.
J Minim Invasive Gynecol
; 21(5): 799-803, 2014.
Article
em En
| MEDLINE
| ID: mdl-24681065
ABSTRACT
STUDY OBJECTIVE:
To estimate the prevalence of genital tract diseases in women with initial and recurrent postmenopausal bleeding (PMB) to help inform diagnostic pathways.DESIGN:
Prospective cohort study (Canadian Task Force classification II-2).SETTING:
Large urban teaching hospital. PATIENTS Of 1938 consecutive women with postmenopausal bleeding, 106 (5%) were investigated for a recurrent episode after having normal findings of previous investigations.INTERVENTIONS:
All women underwent pelvic examination and ultrasound scanning. An endometrial biopsy was performed when endometrial thickness was >4 mm in women with a first episode of PMB, with recourse to outpatient hysteroscopy after correlation between clinical and pathologic findings. All women with a recurrent PMB episode underwent endometrial biopsy and outpatient hysteroscopy. MEASUREMENTS AND MAINRESULTS:
The risk of having endometrial cancer or hyperplasia with atypia was significantly less in women with recurrent PMB (9%) as compared with those with a first episode of PMB (8%) (p = .002), but were significantly more likely to have benign endometrial polyps (28%) compared with women with a first episode of PMB (19%) (relative risk, 1.47; 95% confidence interval, 1.07-2.02; p = .02).CONCLUSION:
Recurrent PMB results in less likelihood of premalignant and malignant endometrial disease; however, in 1 of 4 women PMB is caused by endometrial polyps. First-line investigation in women with recurrent PMB should be tests that have high accuracy for enabling diagnosis of focal diseases, such as outpatient hysteroscopy or saline infusion sonography.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pólipos
/
Lesões Pré-Cancerosas
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Hemorragia Uterina
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Neoplasias Uterinas
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Histeroscopia
/
Neoplasias do Endométrio
/
Endométrio
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Incidence_studies
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Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article