Histopathological Evaluation of Hysterectomy Specimens and their Association with Heavy Menstrual/ Abnormal Uterine Bleeding
Abstract
Background: Abnormal Uterine Bleeding patients is one of the most interesting topic for evaluation worldwide; a number of issue will faced while evaluating these patients like terminology and definition among the health professionals, signs and symptoms, and that's why, endometrium is very interesting tissue for research and considered by a continue process of cell division, variation and death in response to sex-hormone secreted by ovaries.
Objectives: To evaluate the histopathological specimens of hysterectomy (blocks and slides) and their association with heavy menstrual/ abnormal uterine bleeding.
Material and Methods: This is a retrospective study conducted in RMI Peshawar; a tertiary care hospital in Peshawar KPK. In this study 312 hysterectomy specimens (blocks and slides) of patients with AUB/HMB during the period of 1st Nov. 2020 to 31st Dec 2022 were included. Data including age, parity, symptoms and clinical indication for hysterectomy was collected for the study. The specimens were processed routinely and stained with hematoxylin and eosin stain and examined microscopically.
Results: Our study consists of 312 of TAH specimens received in Department of histopathology of RMI with HMB/AUB finding. The Age range of patients was 31years to 75years old. The maximum age group was from 41-50 years old (43%) and minimum number of 61years and above group (10.34%), although the later said specimen's malignancy (33%). The histopathological finding were i.e., 41% adenomyoma followed by fibroid 35% endometrial polyp 9% Malignant 6% and 5% each endometrial hyperplasia and otherss. 24% and 29% were fibroid and adenomyoma in the premenopausal women whie In post menopausal the most common are malignant neoplasm and and endometrial polyp 6% and 5% respectively.
Conclusion: Adenomyosis was found to be the most common histopathological finding in hysterectomy specimens of women with Abnormal Uterine Bleeding followed by uterine leiomyoma, while endocervical polyp, endometrial carcinoma and other unknown reason are most commonly finding in postmenopausal women. There is strong association of between adenomyosis and leiomyoma with HMB. Hyperplasia without atypia were equally presentation in both pre and post-menopausal aged groups.
Keywords: Heavy Menstrual Bleeding, Histopathology Rehman Medical Institute
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