Latifi Hajrullah, Gashi Astrit M, Latifi Drilon
Faculty of Medicine, University of Gjakova Fehmi Agani, Kosovo.
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Pristine, Kosovo.
Curr Health Sci J. 2023 Apr-Jun;49(2):151-155. doi: 10.12865/CHSJ.49.02.151. Epub 2023 Jun 30.
Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman's normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women's lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding.
异常子宫出血是一个术语，用于描述子宫的任何不规则出血，这种出血不属于女性正常月经周期的一部分，且可发生在不同的生命阶段。异常子宫出血可由结构性病因（息肉、子宫腺肌病、平滑肌瘤、恶性肿瘤）或非结构性病因（凝血功能障碍、排卵功能障碍及未分类病因）引起。绝经后期和绝经前期需要进行详细检查以确定出血病因，因为在此期间女性患恶性肿瘤的几率较高。治疗方案根据出血的潜在病因来确定。本文的主要目的是确定不同时期子宫内膜癌的患病率，重点关注绝经后期。本研究为横断面研究，纳入了79例女性不同生命阶段的异常子宫出血病例。我们的研究发现，异常子宫出血在绝经前期更为常见（59%），且该时期不规则出血的原因主要为良性。我们的研究聚焦于绝经后期，发现该时期32.9%的子宫不规则出血发生在此期间，主要病因是恶性病变（83.3%），主要为子宫内膜腺癌。平均年龄为66.7岁。在研究过程中，观察到因恶性肿瘤导致异常子宫出血的女性中，50%被归类为超重，25%为肥胖，25%体重正常。现已证实肥胖是绝经后期恶性肿瘤的一个协同因素，其病理生理机制已为人熟知。我们的研究还发现，因恶性肿瘤导致异常子宫出血的女性中存在大量合并症。我们得出的结论是，任何异常子宫出血都应首先进行多学科检查，确定准确诊断，然后制定治疗方案。治疗策略应根据异常出血的原因来确定。
