Histopathological spectrum of endometrium in hysterectomy specimens from cases of abnormal uterine bleeding

Introduction: In India, the prevalence of women suffering from abnormal uterine bleeding is around 17%. Dilatation and curettage, endometrial biopsy and hysterectomies play an important role in diagnosis as well as treatment of abnormal uterine bleeding cases. Though number of minimaly invasive surgical options available, hysterectomy remains the widely accepted and practiced treatment of choice. Therefore those cases where causes of bleeding cannot be determined clinically then histological examination of hysterectomy specimen required to establish the etiology of abnormal uterine bleeding.Material and Methods: This was a prospective study conducted for a period of two years in department of pathology in tertiary care hospital, GAIMS, G.K.General hospital, Bhuj, Kutch region in India. Total of 300 women presenting with abnormal uterine bleeding on whom consecutive hysterectomy done were included in the study. Gross examination done and H&Estained section were studied and analyzed according to publish protocols.Results: Total of 495 hysterectomy, 300(61%) of patients presented with abnormal uterine bleeding.86/300(29%) presented with heavy menstrual bleeding. Proliferative phase is the most common histological finding with 128/300(42%), endometrial hyperplasia in 40/300(13%), endometrial carcinoma in 2/300(1%) of women.Conclusion: Abnormal uterine bleeding is age related pathology with common symptom amongst women. Even though medical treatment and conservative surgeries have emerged, hysterectomy is the definitive treatment modality for abnormal uterine bleeding in developing and affluent countries. All hysterectomy specimens even if it appears grossly normal should be subjected for histopathological examination regardless of the preoperative diagnosis, as unsuspected incidental findings can be found in these specimens.