Evaluation of premenopausal period and postmenopausal period patients who had hysterectomy due to abnormal uterine bleeding according to figo palm-coein classification

Aim: Abnormal uterine bleeding (AUC) is an important clinical problem affecting reproductive and postmenopausal women. FIGO has developed a universal classification system for AUC called PALM-COEIN. To diagnose and treat patients undergoing hysterectomy for AUK, it is important to determine the structural causes according to the PALM-COEIN classification. Our study aimed to evaluate the patients who underwent hysterectomy for AUC according to the PALM-COEIN classification. Method: In our study, we examined the histopathological results of patients who underwent hysterectomy for AUC in our hospital between 2020 and 2023. The results of 629 patients who met the inclusion criteria were detailed, and the study was finalised. Results: The mean age of the patients was 49.03 ± 7.95 years; 95.7% were married, 51.8% had a history of chronic disease, and 61.8% were postmenopausal. When the histopathological results of the patients were examined, 28% leiomyoma, 11.5% adenomyosis, 13% adenomyosis and leiomyoma coexistence and 12% malignancy were found. In comparison, 14% patients were found in the group not classified according to PALM-COEIN. Leiomyoma was found in 33.7% of postmenopausal and 19.2% of premenopausal patients with normal findings (no organic pathology-unclassified). The malignancy rate was found to be higher in single patients, premenopausal patients and patients with no history of previous gynaecological/obstetric surgery (p=0.001, p=0.001, p=0.013). Conclusion: A detailed evaluation of the causes of AUC according to the PALM-COEIN classification in patients undergoing hysterectomy and a correct classification of the indications for hysterectomy may contribute to the prevention of unnecessary surgical interventions and direct patients to appropriate treatment. We recommend that the PALM-COEIN classification be routinely used in the 15 preoperative period in patients planning to undergo a hysterectomy for AUC and that each patient's risk factors should be considered.