title: Comparison of classic terminology with the FIGO PALM-COEIN system for classification of the underlying causes of abnormal uterine bleeding.
abstract: 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 18-55years 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology and Obstetrics, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey. Electronic address: emrahtoz79@gmail.com.
authors.forename: Emrah
authors.initials: E
authors.lastname: Töz
authors.affiliation: Department of Gynecology and Obstetrics, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sancı
authors.affiliation: Department of Gynecology and Obstetrics, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Özcan
authors.affiliation: Department of Gynecology and Obstetrics, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Beyan
authors.affiliation: Department of Gynecology and Obstetrics, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey.
authors.forename: Abdurrahman H
authors.initials: AH
authors.lastname: İnan
mesh_terms: D062788:Adenomyosis / Q000453:epidemiology; D000328:Adult; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007889:Leiomyoma / Q000453:epidemiology*; D008595:Menorrhagia / Q000453:epidemiology*; D008796:Metrorrhagia / Q000453:epidemiology*; D008875:Middle Aged; D011127:Polyps / Q000453:epidemiology; D012189:Retrospective Studies; D012955:Societies, Medical; D009626:Terminology as Topic; D014421:Turkey; D014592:Uterine Hemorrhage / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult
keywords: Abnormal uterine bleeding; Classic terminology; Menometrorrhagia; PALM-COEIN