Histopathological Spectrum of Abnormal Uterine Bleeding in Upper Egypt: A Study of 676 Cases

Objective: AUB is one of the most serious problems that face females all over the world not only through their reproductive age but also after menopause. This study aims to determine the types and frequencies of pathological causes of AUB in Upper Egypt women aged in different age groups and to study the necessity and significance of endometrial curetting in abnormal uterine bleeding. Methods: A Retrospective study carried out on 676 specimens obtained by from patients with AUB. Data is being received from clinical and pathological records at Assuit University Hospital covering the period of 3 years from April 2015- April 2018. The total tissue submitted was processed and examined in details microscopically by the pathologist. Results: A total of 676 cases with AUB, Endometrial polyp seen in 37.9% (the most common). Leiomyoma was seen in 9.2%. Complication of pregnancy (8%), disordered proliferative endometrium (6.8%), adenomyosis (5.9%), proliferative endometrium (4.7%), endometritis (4.1%), Abnormal secretory phase pattern (2.1%), simple hyperplasia without atypia (3.6%) and complex hyperplasia with atypia (6.2%). Both secretory endometrium and endometrium with evidence of exogenous hormone therapy had the same percentage (2.4%). Finally, malignancy was seen in (5.3%) cases. Conclusion: We conclude that Endometrial polyp, endometrial hyperplasia, and Leiomyoma represent the most common causes of abnormal uterine bleeding in Egyptian women, so as organic causes of abnormal uterine bleeding represent a high percentage, we can say that endometrial curetting and biopsy as a diagnostic procedure has an important role in AUB patients. Histological diagnosis of different pathologies help in their treatment easily once diagnosed and also helps in prophylaxis against malignancy transformation and progression.