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Ann Geriatr Med Res  <  Volume (); 1999 <  Articles

Annals of Geriatric Medicine and Research  
Clinicopathologic characteristics and causes of postmenopausal bleeding in older patients
Hyen Chul Jo1, Jong Chul Baek1 , Ji Eun Park1, Ji Kwon Park1, In Ae Cho2, Won Jun Choi2, Joo Hyun Sung3
1Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Gyeongsang National University, Changwon, Korea
2Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea
3Department of Occupational and Environmental Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University, Changwon, Korea
Correspondence to: Jong Chul Baek, MD, PhD
https://orcid.org/0000-0003-0919-0800
Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea
Tel: +82-55-214-3781
Fax: +82-55-759-1118
E-mail: gmfather@gmail.com
Received: October 25, 2018; Revised: November 21, 2018; Accepted: November 23, 2018; Published online: December 26, 2018.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: This study aimed to reveal the clinicopathologic features and causes of bleeding in older patients with postmenopausal bleeding (PMB) and to investigate the correlation between the ultrasonographic findings and etiology of PMB. Methods: We retrospectively analyzed the causes and clinical characteristics of PMB in 498 patients who were diagnosed between January 2007 and December 2017. The population with PMB was divided into 2 groups according to age: Group A (n=204) included individuals more than 65 years of age and group B (n=294) included those less than 65 years of age. Clinical characteristics such as age, parity, underlying conditions, previous surgical history, and previous menopausal hormone therapy were compared between the groups. Cervical cytology testing and transvaginal ultrasonography were performed in all patients with PMB. Endometrial biopsy was performed in all cases of endometrial thickness ≥5 mm. Results: We examined 498 patients with PMB. In group A, atrophic endometrium (n=125, 61.27%) was the most common cause of PMB. Twenty-three patients had gynecological malignancy (cervical cancer: n=12, 5.88%; endometrial cancer: n=8, 3.42%; ovarian cancer: n=3, 1.46%), and 30 patients had benign gynecological disease (endometrial polyp: n=10, 4.90%; submucosal myoma: n=6, 2.94%; uterine prolapse: n=7, 3.42%; cervical dysplasia; n=5, 2.45%; cervical polyp: n=2, 0.98%). Forty patients had endometrial thickness ≥5 mm. Eight patients were diagnosed with endometrial cancer. All cases of endometrial cancer were diagnosed with endometrial thickness >10 mm. Conclusion: Atrophic endometrium was the most common cause of PMB in both groups, and approximately 12% of cases were associated with gynecological malignancy in older patients.
Keywords: Postmenopause, Vaginal bleeding, Elderly


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