الفهرس 
Postmenopausal BleedingOnly 14 pages are availabe for public view
 |  | from | 171 |  |  |
| | | from | 171 | | |
Abstract
The menopause, as defined by the World Health Organization, is a permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Postmenopausal bleeding (PMB), defined as blood loss occurring at least 12 months after menopause, is a common complaint in general gynecological practice. The prevalence of PMB is approximately 10% immediately after menopause. The main objective in the diagnostic work up of postmenopausal women presenting with abnormal uterine bleeding is to detect or rule out endometrial cancer. Approximately 90% of women with endometrial carcinoma report vaginal bleeding as their only complaint, so this symptom should always be carefully investigated. However, just 10-15% of women with postmenopausal bleeding have endometrial carcinoma. Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal woman. All postmenopausal women with unexpected uterine bleeding patients should be evaluated for endometrial carcinoma since this potentially lethal disease will be the cause of bleeding in approximately 10 percent (range 1 to 25 percent, depending upon risk factors). However, the most common cause of bleeding in these women is atrophy of the vaginal mucosa or endometrium. In the early menopausal years, endometrial hyperplasia, polyps, and submucosal fibroids are also common etiologies. Patients and Methods. This is a Diagnostic Test Accuracy study (DTA) which was conducted over 12 months from December 2015, to December 2016 on postmenopausal women who were approached, managed and followed up in the Early Cancer Detection Unit (ECDU) of Ain Shams University Maternity Hospital to compare between two diagnostic methods Flush and Brush cytology. Study Population: The study population comprises eighty (80) women with postmenopausal bleeding, fulfilling the inclusion criteria, planned for diagnostic hysteroscopy and endometrial biopsy in the (ECDU) of Ain Shams University Maternity hospital, during the study period. Conclusion, Flush and brush are simple methods, associated with comparable pain scores. However, they have modest tissue yield which limits their clinical applicability in the screening of endometrial abnormalities in patients with postmenopausal bleeding. This could be attributed, at least in part, due to the inherent lower diagnostic efficiency of conventional cytology compared to liquid-based cytology, which might prove a more promising method of cytological assessment with these methods.