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Comparison of classic terminology with the FIGO PALM‐COEIN system for classification of the underlying causes of abnormal uterine bleeding
Author(s) -
Töz Emrah,
Sancı Muzaffer,
Özcan Aykut,
Beyan Emrah,
İnan Abdurrahman H
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.09.033
Subject(s) - adenomyosis , medicine , adenomyoma , myoma , hysterectomy , metrorrhagia , gynecology , endometrial polyp , leiomyoma , endometriosis , malignancy , retrospective cohort study , endometrial hyperplasia , obstetrics , hysteroscopy , surgery , uterus , endometrium , pathology , population , family planning , environmental health , research methodology
Objective To compare classic terminology and the PALM‐COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory disorders, endometrium, iatrogenic, and not classified) classification system among women who underwent surgery for abnormal uterine bleeding (AUB), and to subclassify the components of the PALM group for future studies. Methods In a retrospective study, data were obtained for nonpregnant women aged 18–55 years who underwent hysterectomy, myomectomy, or polypectomy for AUB at a center in Turkey in 2014. The patients were retrospectively classified according to the PALM‐COEIN system, and the two terminologies were compared. Results : A total of 471 women were included. The term “hypermenorrhea” covered 15 different pathology combinations, “menorrhagia” nine, “metrorrhagia” 14, and “menometrorrhagia” 18. Of 92 patients with polyp, 5 (5.4%) had two polyps and 1 (1.1%) had three. Of 146 patients with adenomyosis, 131 (89.7%) had diffuse adenomyosis and 12 (8.2%) had adenomyoma. Of 309 patients with myoma uteri, 108 (34.9%) had submucous myoma and 201 (65.1%) had other types of myoma. Conclusion Classic terminology for AUB is insufficient and confusing with respect to etiologic pathologies among nonpregnant women of reproductive age. Widespread adoption of the PALM‐COEIN system for AUB classification will facilitate more meaningful communication among both clinicians and investigators, and clarify the populations that should be evaluated in clinical trials, thereby enhancing communication with patients.