The frequency of structural causes (PALM) according to FIGO PALM-COEIN classification in patients undergoing hysterectomy for abnormal uterine bleeding

Year 2024, Volume: 5 Issue: 3, 172 - 176, 28.06.2024

Enes Akdan , Neşe Yücel , Fikriye Işıl Adıgüzel

https://doi.org/10.47582/jompac.1483113

Abstract

Aims: We aimed to determine the frequency of the PALM group in the FIGO PALM-COEIN system of patients who were operated for AUB, and to evaluate and analyze our data in our clinic.
Methods: In a retrospective study, data were obtained for nonpregnant women aged 18–55 years who underwent hysterectomy for AUB at a center in Turkey in 2017-2022. The patients were retrospectively classified according to the PALM-COEIN system.
Results: A total of 847 women were included. Leiomyoma was the most common pathology result in only 377 (44.5%) patients. The second most common pathology result was adenomyosis and leiomyoma coexistence in 132 (15.6%) patients. The third most common pathology result was 62 (7.3%) adenomyosis.
Conclusion: In addition to the combined use of FİGO AUB system 1 and 2 in AUB, the notation grouping may be useful for clinicians in the management of AUB.

Keywords

Abnormal uterine bleeding, PALM-COEIN, notation.

Ethical Statement

Ethics Committee Approval: The study was initiated with the approval of the University of Health Science Adana City Training and Research Hospital Clinical Researches Ethics Committee (Date: 03.11.2022, Decision No:2225).

Thanks

Thank you for your consideration. Sincerely,

Anormal uterin kanama nedeniyle histerektomi uygulanan hastalarda FIGO PALM-COEIN sınıflamasına göre yapısal nedenlerin (PALM) sıklığı

Abstract

Anormal Uterin Kanama Nedeniyle Histerektomi Uygulanan Hastalarda FIGO PALM-COEIN Sınıflamasına Göre Yapısal Nedenlerin (PALM) Sıklığı


Amaç: Kliniğimizde AUB nedeniyle opere edilen hastaların FIGO PALM-COEIN sisteminde PALM grubunun sıklığını belirlemeyi ve verilerimizi değerlendirip analiz etmeyi amaçladık.

Yöntemler: Retrospektif bir çalışmada, 2017-2022 yıllarında Türkiye'deki bir merkezde AUK nedeniyle histerektomi yapılan 18-55 yaş arası gebe olmayan kadınlardan veriler elde edildi. Hastalar retrospektif olarak PALM-COEIN sistemine göre sınıflandırıldı.

Bulgular: Toplam 847 kadın dahil edildi. Leiomyom sadece 377 (%44,5) hastada en sık görülen patoloji sonucuydu. İkinci sıklıkta görülen patoloji sonucu ise 132 (%15,6) hastada adenomyozis ve leiomyomun birlikte bulunmasıydı. Üçüncü en sık görülen patoloji sonucu ise 62 (%7,3) adenomiyozis idi.

Sonuç: AUK'da FİGO AUB sistem 1 ve 2'nin kombine kullanımına ek olarak notasyon gruplandırması AUK yönetiminde klinisyenler için faydalı olabilir.

Anahtar Kelimeler: Anormal uterin kanama, PALM-COEIN, notasyon.

Keywords

Anormal rahim kanaması, PALM-COEIN, notasyon.

References

• Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-194. doi: 10.1111/j.1524-4733. 2007.00168.x
• Toz E, Sanci M, Ozcan A, Beyan E, Inan AH. Comparison of classic terminology with the FIGO PALM-COEIN system for classification of the underlying causes of abnormal uterine bleeding. Int J Gynaecol Obstet. 2016;133(3):325-328. doi: 10.1016/j.ijgo.2015.09.033
• Wouk N, Helton M. Abnormal uterine bleeding in premenopausal women. Am Fam Physician. 2019;99(7):435-443.
• Munro MG, Critchley HO, Fraser IS. The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them? Am J Obstet Gynecol. 2012;207(4):259-265. doi: 10.1016/j.ajog.2012.01.046
• Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-390. doi: 10.1055/s-0031-1287662
• Woolcock JG, Critchley HO, Munro MG, Broder MS, Fraser IS. Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding. Fertil Steril. 2008;90(6):2269-2280. doi: 10.1016/j.fertnstert.2007.10.060
• Fraser IS, Critchley HO, Munro MG, Broder M, Writing Group for this Menstrual Agreement Process. A process designed to lead to international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding. Fertil Steril. 2007;87(3):466-476. doi: 10.1016/j.fertnstert.2007.01.023
• Fraser IS, Critchley HO, Munro MG, Broder M. Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod. 2007;22(3):635-643. doi: 10.1093/humrep/del478
• Munro MG, Critchley HO, Broder MS, Fraser IS, FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113(1):3-13. doi: 10.1016/j.ijgo.2010.11.011
• Munro MG, Critchley HOD, Fraser IS, FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393-408. doi: 10.1002/ijgo.12666
• Munro MG, Critchley HOD, Fraser IS, FIGO Menstrual Disorders Committee. Corrigendum to “The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions” [Int J Gynecol Obstet 143(2018) 393-408.]. Int J Gynaecol Obstet. 2019;144(2):237. doi: 10.1002/ijgo.12709
• Merrill RM. Hysterectomy surveillance in the United States, 1997 through 2005. Med Sci Monit. 2008;14(1):CR24-CR31
• Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107. doi: 10.1067/mob.2003.99
• Serden SP, Brooks PG. Treatment of abnormal uterine bleeding with the gynecologic resectoscope. J Reprod Med. 1991;36(10):697-699.
• Stewart EA, Nicholson WK, Bradley L, Borah BJ. The burden of uterine fibroids for African-American women: results of a national survey. J Womens Health (Larchmt). 2013;22(10):807-816. doi: 10.1089/jwh.2013.4334
• Ferraz Z, Nogueira-Martins N, Nogueira-Martins F. Adenomyosis: back to the future? Facts Views Vis Obgyn. 2017;9(1):15-20.
• Studzinski Z, Filipczak A, Branicka D. The analysis of the coexistence of endometrial carcinoma and uterine myoma. Ginekol Pol. 2000;71(3):123-129.
• Kinay T, Ozturk Basarir Z, Firtina Tuncer S, Akpinar F, Kayikcioglu F, Koc S. Prevalence of endometrial polyps coexisting with uterine fibroids and associated factors. Turk J Obstet Gynecol. 2016;13(1):31-36. doi: 10.4274/tjod.36043
• Salim S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol. 2011;18(5):569-581. doi: 10.1016/j.jmig.2011.05.018
• Taran FA, Stewart EA, Brucker S. Adenomyosis: epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy. Geburtshilfe Frauenheilkd. 2013;73(9):924-931. doi: 10.1055/s-0033-1350840
• Wynants L, Verbakel JYJ, Valentin L, et al. The risk of endometrial malignancy and other endometrial pathology in women with abnormal uterine bleeding: an ultrasound-based model development study by the IETA Group. Gynecol Obstet Invest. 2022;87(1):54-61. doi: 10.1159/000522524
• Vijayaraghavan A Sr, Jadhav C, Pradeep B, Bindu H, KumaranS. A Histopathological study of endometrial biopsy samples in abnormal uterine bleeding. Cureus. 2022;14(11):e31264. doi:10.7759/cureus.31264