Advertisement

Archives of Gynecology and Obstetrics

, Volume 295, Issue 4, pp 935–941 | Cite as

Comorbidity profiles among women with postcoital bleeding: a nationwide health insurance database

  • Hsin-Li Liu
  • Chuan-Mei Chen
  • Lee-Wen Pai
  • Yueh-Juen Hwu
  • Horng-Mo Lee
  • Yueh-Chin Chung
General Gynecology

Abstract

Purpose

Most of the existing studies on postcoital bleeding (PCB) in Western countries. To date, no study has focused on the various PCB-related comorbidities in Taiwan women. This work aims to analyze and compare the presence or absence of PCB among Taiwanese women with gynecological comorbidity.

Methods

This study is a population-based retrospective cohort investigation. Outpatients with PCB after the index date were considered. A total of 2377 female patients with PCB (ICD-9 626.7) were identified using a nationwide outpatient sample from 2001 to 2010. For comparison, 7131 cases were randomly matched with the study group in terms of gender and age.

Results

The PCB incidence rate was 39–59 cases/100,000 Taiwanese women, with mean age (±SD) of 36.74 ± 10.79 years, median age of 36 years, and mode age of 29 years. Women with PCB exhibited 1.47-fold risk of cervical dysplasia and 1.59-fold risk for malignant neoplasm of cervix. Young women with PCB showed high risk of cervical cancer. The most common benign diseases among PCB- related comorbidities were cervical erosion and ectropion (20.66%), followed by vaginitis and vulvovaginitis (19.18%). Comparison between PCB and non-PCB groups indicated several significant high-risk comorbidities including cervical polyps, cervical erosion, leukoplakia of cervix, intrauterine contraceptive device, cervicitis, vaginitis, menopause, dyspareunia, and vulvodynia.

Conclusions

This study provides evidence that PCB-related comorbidities manifested benign diseases (51.58%), lower genital tract infection (46.11%), and cervical cancer (2.31%). Thus, healthcare providers must ensure that appropriate routine screening tests and counseling are given to women with PCB.

Keywords

Postcoital bleeding Comorbidity Cervical dysplasia Cervical erosion Gynecology infection 

Notes

Author contributions

HLL, MSN: conceptualization: lead; data curation: lead; formal analysis: lead; investigation: lead; writing—original draft: lead; writing—review and editing: lead; CMC, MSN: conceptualization: supporting; data curation: supporting; LWP, MSN: data curation: supporting; formal analysis: supporting; YJH, ph.D.: conceptualization: supporting; methodology: supporting; HML, ph.D.: conceptualization: supporting; methodology: supporting; YCC, Ph.D.: conceptualization: lead; data curation: equal; formal analysis: equal; writing—review and editing: equal.

Compliance with ethical standards

Funding

This study was supported by a Grant from the Central Taiwan University of Science and Technology (CTU105-P-05).

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Because the requested patient data were completely anonymous, not identifiable and retrospective collected between 2001 and 2010, this study was exempt for informed consent from all participants.

References

  1. 1.
    Alfhaily F, Ewies AA (2009) Postcoital bleeding: a study of the current practice amongst consultants in the United Kingdom. Eur J Obstet Gynecol Reprod Biol 144:72–75CrossRefPubMedGoogle Scholar
  2. 2.
    Fraser IS, Petrucco OM (1996) Management of intermenstrual and postcoital bleeding, and an appreciation of the issues arising out of the recent case of O’Shea versus Sullivan and Macquarie pathology. Aust N Z J Obstet Gynaeco 36:67–73Google Scholar
  3. 3.
    Viikki M, Pukkala E, Hakama M (1998) Bleeding symptoms and subsequent risk of gynecological and other cancers. Acta Obstet Gynecol Scand 77:564–569CrossRefPubMedGoogle Scholar
  4. 4.
    Lindner LE, Geerling S, Nettum JA, Miller SL, Altman KH (1988) Clinical characteristics of women with chlamydial cervicitis. J Reprod Med 33:684–890PubMedGoogle Scholar
  5. 5.
    Shapley M, Jordan K, Croft PR (2004) An epidemiological survey of symptoms of menstrual loss in the community. Br J Gen Pract 54:359–363PubMedPubMedCentralGoogle Scholar
  6. 6.
    Shapley M, Jordan J, Croft PR (2006) A systematic review of post coital bleeding and risk of cervical cancer. Br J Gen Pract 56:453–460PubMedPubMedCentralGoogle Scholar
  7. 7.
    Mawajdeh SM, Al-Qutob RJ, Farag AM (2003) Prevalence and risk factors of genital prolapse. Saudi Med J 24:161–165PubMedGoogle Scholar
  8. 8.
    Sahu B, Latheef R, Magd SA (2007) Prevalence of pathology in women attending colposcopy for postcoital bleeding with negative cytology. Arch Gynecol Obstet 276:471–473CrossRefPubMedGoogle Scholar
  9. 9.
    Selo-Ojeme DO, Dayoub N, Patel A, Metha M (2004) A clinico-pathological study of postcoital bleeding. Arch Gynecol Obstet 270:34–36CrossRefPubMedGoogle Scholar
  10. 10.
    Rosenthal AN, Panoskaltsis T, Smith T, Soutter WP (2001) The frequency of significant pathology in women attending a general gynaecological service for postcoital bleeding. BJOG 108:103–106Google Scholar
  11. 11.
    Pardanani NS, Tischler LP, Brown WH, Feo ED (1975) Carcinoma of cervix. Evaluation of treatment in community hospital. N Y State J Med 75:1018–1021PubMedGoogle Scholar
  12. 12.
    Pretorius R, Semrad N, Watring W, Fotheringham N (1991) Presentation of cervical cancer. Gynecol Oncol 42:48–53CrossRefPubMedGoogle Scholar
  13. 13.
    Shalini R, Amita S, Neera MA (1998) How alarming is post-coital bleeding—a cytologic, colposcopic and histopathologic evaluation. Gynecol Obstet Invest 45:205–208CrossRefPubMedGoogle Scholar
  14. 14.
    Jha S, Sabharwal S (2002) Outcome of colposcopy in women presenting with postcoital bleeding and negative or no cytology-results of a 1-year audit. J Obstet Gynaecol 22:299–301CrossRefPubMedGoogle Scholar
  15. 15.
    Anorlu RI, Abdul-Kareem FB, Abudu OO, Oyekan TO (2003) Cervical cytology in an urban population in Lagos, Nigeria. J Obstet Gynaecol 23:285–288CrossRefPubMedGoogle Scholar
  16. 16.
    Greenlee RT, Hill-Harmon MB, Murray T, Thun M (2001) Cancer statistics, 2001. CA Cancer J Clin 51:15–36Google Scholar
  17. 17.
    Marshall, K (2003) Cervical dysplasia: early intervention.(Cervical Dysplasia). Altern Med Rev 8:156–171Google Scholar
  18. 18.
    Kobayashi D, Takahashi O, Hikosaka C, Okubo T, Fukui T (2013) Optimal cervical cytology mass screening interval for cervical cancer. Arch Gynecol Obstet 287:549–554CrossRefPubMedGoogle Scholar
  19. 19.
    Gupta K, Malik NP, Sharma VK, Verma N, Gupta (2013) A prevalence of cervical dysplasia in western Uttar Pradesh. J Cytol 30:257–262CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Chitale AR, Bhuvaneshwari, Krishna UR (1976) Histological assessment of cytologically abnormal smears. Indian J Cancer 13:324–329PubMedGoogle Scholar
  21. 21.
    Nher H, Lamminger C, Zimmermann J, Petzoldt D (1991) The value of symptoms and clinical findings in cervical Chlamydia trachomatis infection. Hautarzt 42:687–691PubMedGoogle Scholar
  22. 22.
    Khattab AF, Ewies AA, Appleby D, Cruickshank DJ (2005) The outcome of referral with postcoital bleeding (PCB). J Obstet Gynaecol 25:279–282CrossRefPubMedGoogle Scholar
  23. 23.
    Chen MY, Rohrsheim R, Donovan B (2005) Chlamydia trachomatis infection in Sydney women. Aust N Z J Obstet Gynaecol 45:410–413CrossRefPubMedGoogle Scholar
  24. 24.
    Götz HM, van Bergen JE, Veldhuijzen IK et al (2005) A prediction rule for selective screening of Chlamydia trachomatis infection. Sex Transm Infect 81:24–30Google Scholar
  25. 25.
    Hakama M, Joutsenlahti U, Virtanen A, Rasanen U (1975) Mass screenings for cervical cancer in Finland 1963–1971. Ann Clin Res 7:101–111PubMedGoogle Scholar
  26. 26.
    Hakama M, Pukkala E (1977) Selective screening for cervical cancer. Experience of the Finnish mass screening system. Br J Prev Soc Med 31:238–244Google Scholar
  27. 27.
    Christopher M, Tarney, Jasmine Han (2014) Postcoital bleeding: a review on etiology, diagnosis, and management. Obstet Gynecol Int 192087. doi: 10.1155/2014/192087
  28. 28.
    Bianchi S, Boveri S, Igidbashian S, Amendola A, Urbinati A MV, Frati ER, Sideri M (2016) Chlamydia trachomatis infection and HPV/Chlamydia trachomatis co-infection among HPV-vaccinated young women at the beginning of their sexual activity. Arch Gynecol Obstet 294:1227–1233CrossRefPubMedGoogle Scholar
  29. 29.
    Magalhaes PAF, Miranda, CAN, Lima EG, Moizéis RNC, de Lima DBS, Cobucci R N O, Fernandes JV (2015) Genital tract infection with Chlamydia trachomatis in women attended at a cervical cancer screening program in Northeastern from Brazil. Arch Gynecol Obstet 291:1095–1102CrossRefPubMedGoogle Scholar
  30. 30.
    Tehranian A, Rezaii N, Mohit M, Eslami B, Arab M, Asgari Z (2009) Evaluation of women presenting with postcoital bleeding by cytology and colposcopy. Int J Gynaecol Obstet 105:18–20Google Scholar
  31. 31.
    Avis NE, Stellato R, Crawford S, Johannes C, Longcope C (2000) Is there an association between menopause status and sexual functioning? Menopause 7:297–309CrossRefPubMedGoogle Scholar
  32. 32.
    Dennerstein L, Dudley EC, Hopper JL, Burger H (1997) Sexuality, hormones and the menopausal transition. Maturitas 26:83–93CrossRefPubMedGoogle Scholar
  33. 33.
    Lee SW, Jo HH, Kim MR, Kwon DJ, You YO, Kim JH (2012) Association between menopausal symptoms and metabolic syndrome in postmenopausal women. Arch Gynecol Obstet 285:541–548CrossRefPubMedGoogle Scholar
  34. 34.
    Liu HL, Lee HM, Chung YC (2015) Dyspareunia and its comorbidities among Taiwanese women: analysis of the 2004 to 2010 nationwide health insurance database. J Sex Med 12:1012–1018CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Hsin-Li Liu
    • 1
  • Chuan-Mei Chen
    • 1
  • Lee-Wen Pai
    • 1
  • Yueh-Juen Hwu
    • 1
  • Horng-Mo Lee
    • 2
  • Yueh-Chin Chung
    • 1
  1. 1.Department of NursingCentral Taiwan University of Science and TechnologyTaichungTaiwan, Republic of China
  2. 2.School of Medical Laboratory Sciences and BiotechnologyTaipei Medical UniversityTaipeiTaiwan, Republic of China

Personalised recommendations