Postmenopausal bleeding - ppt download

Postmenopausal bleeding Postmenopausal bleeding (PMB) is defined as vaginal bleeding after the menopause. Menopause is permenant cessation of menstruation that diagnose after 12 months of amenorrhea in a middle aged woman.
Majority of PMB is result from benign cause. Around 10 percent of women with PMB will be found to have endometrial cancer.
Uterus: Atrophic endometritis. Endometrial polyp. Endometrial hyperplasis. Endometrial carcinoma. Uterine sarcoma.
Cervical: Polyp. cancer. Vaginal: Atrophic vaginitis, local trauma from ring/shelfpessary. cancer (rare).
Ovarian tumor: secreting hormone or pelvic vessel congestion. extra genital bleeding may be mistaking as vaginal bleeding: GIT:cancer, diverticulitis, inflammatory bowel disease),hemorrhoids. urethral caruncle, urethral diverticula, urethral prolapse/eversion,ca,heamaturia .
Atrophic vaginitis or endometritis 40-60% Endometrial hyperplasia 12% Endometrial cancer 10%
History. Examination. Investigatiion.
Any episoides of menopausal bleeding should be investigated. Severity and duration of bleeding. Post coital bleeding : cx polyp or ca. Risk factors for ca of endometerium. Hx of loss wt or appetite. Drug history of anticoagulant,HRT , tamoxifene.
Abdomen: Assess for masses. Speculum: Assess vulva, vagina(atrophy or malignancy )and cervix( polyp,malignancy) Bimanual palpation :uterin size,mobility or adenaxial masses.
Tissue diagnosis: out patient Pipelle biopsy,D&C. hysteroscopy.
Endometrial thickness : 4mm or more in menopausal bleedingor 5mm or more for post menopausal on RHT is indicated for endometrial biosy. Myometrial masses. adenaxial mass.
Thin endometrium in postmenopausal bleeding by TVU
Hysterosonograpgy for suspected endometerial polyp on USS
Focal thickness on TVU. Inadequate biopsy. Persistent VB with negative biopsy.
Atrophic vaginitis or endometritis( HRT. Cervical polyp :polypectomy. Endometerial polyp: removal under direct visulization by hysteroscopy.
Without atypia: high dose oral progestogen or Mirena. With atypia : TAH.
TAH+ BSO+ staging+ adjuvant therapy.

Postmenopausal bleeding for undergraduate

Post menopausal bleeding

Post menopausal bleeding - ppt download

Post menopausal bleeding - ppt download

Postmenopausal bleeding for undergraduate

Post menopausal bleeding

UOG Journal Club: July 2019 Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: - ppt download

Post menopausal bleeding - ppt download

Post menopausal bleeding

Post menopausal bleeding - ppt download

Post menopausal bleeding

Post menopausal bleeding

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