Abstract
Objective: Minor bleeding that occurs for several days around ovulation is called intermenstrual or ovulation bleeding, and is classified as a type of menometrorrhagia with no organic abnormalities. We investigated the possibility that this condition may be related to intrauterine abnormalities.
Methods: Sixty-one patients with regular menstrual cycles (24-48 years of age), who complained of intermenstrual bleeding (IMB) comprised the study group. Examinations included transvaginal ultrasonography (USG) and hysteroscopy during the early follicular phase.
Results: Diagnoses based on hysteroscopy revealed endometrial polyps (E. polyps) in 55 patients (90.2%) . Including 4 cases of submucosal myomas and 2 cases of cervical polyps in the uterine cavity, intrauterine lesions were found in a total of 59 patients (with overlap in 2 patients; 96.7%) . E. polyps were observed in 6 patients who had no abnormalities on USG. For the 53 patients who onlyhad E. polyps, the findings on USG primarily included irregular echo patterns in patients with ≤4 polyps and tumor images in patients with 1-3 polyps (p<0.001) . Tumor images were observed for polyps ≥5 mm. In patients who were examined closely, IMB usually occurred prior to follicle rupture.
Conclusion: E. polyps and other protrusive lesions in the uterine cavity were observed in 96.7% of patients with IMB. These lesions were thus considered a possible cause of IMB. Organic abnormalities must thus be considered as causes of IMB. In addition, as not all protrusive lesions in the uterine cavity could be confirmed based on USG alone, hysteroscopy appears necessary for complete detection.
