Comparison Of Endometrial Thickness Measured By Transvaginal Ultrasonography And Histopathologic Outcome In Premenopausal Patients With Abnormal Uterine Bleeding

Yıl 2019, Cilt: 16 Sayı: 2, 93 - 96, 01.04.2019

Erdem Şahin İlknur Çöl Madendağ Mefkure Eraslan Şahin Yusuf Madendağ Gökhan Açmaz Fatma Özdemir Ahmet Emin Mutlu İptisam İpek Muderris

Öz

Aim: This study aimed to evaluate endometrial thickness that measured with transvaginal ultrasonography TvUSG and histopathological results in women with abnormal uterine bleeding during perimenopausal period.Material and Methods: This retrospective study was conducted between March 2017 and May 2018 with the evaluation of 280 premenopausal patients between 35-50 years old who admitted to our clinic with abnormal uterine bleeding. Endometrial thickness was measured by TvUSG and mean endometrial thicknesses were evaluated according to histopathologic results of the patients. A normal endometrium biopsy is defined as a proliferative and secretory endometrium, and an abnormal endometrium as a polyp, simple or complex hyperplasia and endometrium cancer.Results: A total of 280 patients were included. 202 72.1% patients were reported histopathologically normal endometrium and 78 27.9% were abnormal endometrium. Mean age was 42 ± 4.2, median gravida 4 0- 10 , median parity 3 0-7 and mean body mass index 27.5±2.64 kg/ m2 were determined. Proliferative endometrium and secretory endometrium were the most frequent histopathologic findings with mean endometrial thickness of 7.13±3.81 mm and 8.42 ± 3.92 mm, respectively. Endometrial polyps were reported in 40 14.2% patients, simple endometrial hyperplasia in 33 11.7% patients and complex endometrial hyperplasia in 3 1.7% patients with abnormal histopathologic results and mean endometrial thicknesses were 13.41 ± 6.75 mm, 13.20 ± 7.75 mm and 14.54 ± 6.80 mm, respectively. 2 0.3% patients had endometrial cancer and the mean endometrial thickness was 21.41±2.75 mm.Conclusion: TvUSG is a non-invasive, safe and successful method that may be preferred as the first step in evaluating endometrial pathologies in premenopausal patients for abnormal uterine bleeding.

Anahtar Kelimeler

Premenopause, abnormal uterine bleeding, transvaginal ultrasonography, endometrial thickness

Anormal Uterin Kanaması Olan Premenopozal Hastalarda Transvajinal Ultrasonografi İle Ölçülen Endometrial Kalınlık İle Histopatolojik Sonuçların Karşılaştırılması

Öz

Amaç: Bu çalışma perimenopozal dönemde anormal uterin kanaması olan kadınlarda transvajinal ultrasonografi TvUSG ile değerlendirilen endometrial kalınlık ile histopatolojik sonuçlarla karşılaştırılarak TvUSG’nin anormal endometrial biyopsi sonuçlarını tespit edebilme başarısını araştırmayı amaçlamaktadır.Gereç ve Yöntemler: Bu retrospektif çalışma Mart 2017- Mayıs 2018 yılları arasında anormal uterin kanama şikayeti ile polikliniğe başvurun 35-50 yaş arasında 280 premenopozal hastanın değerlendirilmesi ile yapılmıştır. TvUSG ile endometrial kalınlık ölçülerek hastaların histopatolojik sonuçlarına göre ortalama endometrial kalınlıkları değerlendirildi. Normal endometrium, biyopsi sonucunun proliferatif ve sekretuar endometrium; anormal endometrium ise biyopsi sonucu polip, basit veya kompleks hiperplazi ve endometrium kanseri olarak tanımlandı.Bulgular: Çalışmaya toplam 280 hasta dâhil edildi. Ortalama yaş 42±4.2 olup, ortanca gravida 4 0-10 , ortanca parite 3 0-7 ve ortalama vücut kitle indeksi 27.5±2.64 kg/m2 tespit edildi. Histopatolojik olarak 202 %72.1 hastada normal endometrium 78 %27.9 hastada anormal endometrium olarak raporlandı. Proliferatif endometrium ve sekretuar endometrium en sık histopatolojiler olup bu hastalarda ortalama endometrial kalınlık sırası ile 7.13±3.81 mm ve 8.42±3.92.mm saptanmıştır. Anormal histopatolojik sonuçlara bakıldığında 40 %14.2 hastada endometrial polip, 33 %11.7 hastada basit endometrial hiperplazi ve 3 %1.7 hastada kompleks endometrial hiperplazi olarak raporlanmış olup ortalama endometrial kalınlıklar sırası ile 13.41±6.75 mm, 13.20±7.75 mm ve 14.54±6.80 mm olarak değerlendirilmiştir. 2 %0.3 hastada endometrial kanser tespit edilmiş olup ortalama endometrial kalınlık 21.41±2.75 mm olarak ölçülmüştür.Sonuç: TvUSG, anormal uterin kanaması olan premenopozal hastalarda endometrial patolojileri değerlendirmede ilk basamak olarak tercih edilebilecek başarılı bir yöntemdir

Anahtar Kelimeler

Premenopoz, anormal uterin kanama, transvajinal ultrasonografi, endometrial kalınlık

Kaynakça

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