Transvaginal sonography for the evaluation of postmenopausal bleeding

Abstract EN

Objective: To evaluate the effectiveness of transvaginal sonography in assessing the endometrial thickness in patients with postmenopausal uterine bleeding.

This will be studied in relation to the histopathological results of the endometrial biopsy, so as to detect its accuracy to diagnose endometrial cancer without the need for dilatation and curettage. Methods: A total of 123 women with ages varying from 50 to 65 years, who were diagnosed with /or had postmenopausal bleeding.

Their history was taken and a general examination was done.

However, patients who had the risk of having endometrial carcinoma or those undertaking hormonal therapy were excluded from the study.

All patients were examined with the transvaginal ultrasound to measure the endometrial thickness, and scheduled for endometrial sampling by dilatation and curettage, then compare the histological findings with the sonographic results. Results: The study was based on a cut-off value of endometrial thickness 5mm or less to exclude malignancy, and the patients were classified according to endometrial measurement into 5.6-19 and more than 20mm. Seventy two patients had atrophic endometrium; endometrial thickness was 1.7-3mm, while 37 patients with the thickness of 6.3-8.

lmm had uterine polyps. Simple hyperplasia was found in 9 patients and the endometrial thickness was 10.1-13mm, and in four patients complex hyperplasia was found with an endometrial thickness of 14-17.5mm. One patient had endometrial carcinoma with an endometrial thickness of 25.3mm. Conclusion: Transvaginal sonography investigation for postmenopausal bleeding may provide useful information for patients under high risks of endometrial abnormalities.

When using such a technique for measuring the endometrial thickness in women with postmenopausal bleeding, it is reasonable not to perform a dilatation and curettage if the endometrial thickness is < 5 mm.