Evaluation of endometrial abnormalities in asymptomatic women with endometrial thickening or hydrometra in Alzahra Hospital

Abstract

This study aimed to evaluate the association between endometrial pathologies with incidental abnormal sonographic findings of endometrium in postmenopausal women. Materials and Methods: In this analytical cross-sectional study, the target population were those who underwent trans-abdominal and vaginal ultrasonography of the uterus for reasons other than uterine bleeding, referring to Al-Zahra Teaching Hospital of Tabriz University of Medical Sciences. Among the eligible women, 86 women consented to undergo intrauterine sampling and pap-smear if intra-uterine fluid or endometrial thickening (above 5 mm) was detected. Histopathology results were recorded. IBM SPSS (26) was used for examining the hypothesized associations. A p-value of 5% or lower is considered to be statistically significant. Results: The median age of the patients was 55 years, IQR: [51-60]. The most common chief complaint of patients at the time of referral was pain (54.65%), of which abdominal pain was the most frequent type. Of these, 20.93% of patients came in for annual gynecological control. Among those with endometrial thickening (above 5 mm), endometrial thickness between 5 and 8 mm, comprised 41.86% of the samples, which was the most common sonographic finding. Pearson's correlation analysis did not show a relationship between endometrial thickness with age or patients' BMI (p=0.183 and p=0.386; respectively). Pap smear results reported "no-pathology" in 73.25% of participants, Squamous Cell carcinoma in 1(%). Other pap-smear were reported to have inflammation. There is no statistically significant relationship between endometrial thickness and endometrial biopsy pathology findings (X (27)=36.49; p=0.105). The most common finding in endometrial biopsies was atrophic endometrium (34.88%), accompanied by polyps in 2.33% of patients. The second common finding was the presence of polyps, which had a frequency of 15.15%. Normal pathology was reported in 16.28% of patients. No statistically significant relationship was observed between Pap smear results and pathology of endometrial biopsy (X(63)=78.86; p=0.146). In patients with endometrial thickness greater than 8 mm, there were 11 cases (23.4%) of polyps, and 9 cases (19.1%) of abnormal endometrial proliferation. Polyps with endometrial proliferation were also observed in 2 cases.