Related Experiment Videos
Vaginal ultrasonography in patients with postmenopausal bleeding
R Auslender1, J Bornstein, M Dirnfeld
1Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.
Summary
Postmenopausal bleeding can be managed by measuring endometrial thickness. A thickness of 3 mm or less in women with postmenopausal bleeding indicates atrophy, safely omitting endometrial sampling and reducing procedures by 45%.
Area of Science:
- Gynecology
- Diagnostic Imaging
- Pathology
Background:
- Postmenopausal bleeding requires investigation, often involving endometrial sampling.
- Current diagnostic protocols may lead to unnecessary procedures.
Purpose of the Study:
- To identify women with postmenopausal bleeding who can safely avoid endometrial sampling.
- To correlate vaginal endosonographic measurements with histological findings.
Main Methods:
- Compared vaginal endosonography to histological findings in 129 women with postmenopausal bleeding.
- Analyzed endometrial thickness in relation to histological diagnoses (atrophy, polyps, adenocarcinoma).
Main Results:
- Endometrial atrophy was diagnosed in 49% of cases.
- A sonographic endometrial thickness of 3 mm or less was strongly associated with atrophic endometrium (p < 0.0001).
- An endometrial thickness threshold of 3 mm or less could have reduced dilation and curettage procedures by 45% without missing pathologies.
Conclusions:
- Vaginal endosonography can accurately identify atrophic endometrium in women with postmenopausal bleeding.
- A 3 mm or less endometrial thickness threshold can safely select women for whom endometrial sampling can be omitted.
- This approach can significantly reduce the number of invasive procedures.