POSTCOITAL BLEEDING IN WOMEN ATTENDING A TERTIARY CARE HOSPITAL

Abstract

Objective: To document the frequency of different pathologies in women with postcoital bleeding. To determine the frequency whether abnormal bleeding with positive cervical smear increases the risk of serious pathology. Design: Descriptive study. Place and Duration of Study: Military Hospital Rawalpindi from 1st June 2000 to 30th June 2002. Patients and Methods: A descriptive study was carried out in Military Hospital Rawalpindi from 1st June 2000 to 30 June 2002. A total of 157 Women were included in the study. The inclusion criteria were women with postcoital bleeding and having positive cervical smear along with abnormal bleeding. Evaluation was done by a detailed history followed by cervical smear, followed by colposcomic examination as well as cervical and endometrial biopsies and in some cases vaginal biopsies. The main outcome measure was histopathological diagnosis. Results: Eight women (5.1%) had invasive cancer. Five were cervical, one vaginal cancer and two endometrial cancer. Five of the 6 cervical or vaginal cancers were clinically apparent. One woman of the 6 had a normal smear before being further investigated for Postcoital bleeding. Cervical intraepithelial neoplasia was found in 15 women (9.6%) and 7 women (4.4%) had cervcal polyp. No explanation for the postcoital bleeding was found in 89 women (56.7%) Conclusion: Invasive cancer is rare in women with postcoital bleeding. Postcoital bleeding should be regarded as an indication of high risk so all women must undergo colposcopic examination.