Correlation of endometrial ultrasonography and endometrial histopathology in patients with postmenopausal bleeding

A retrospective study of 49 cases with persistent postmenopausal vaginal bleeding undergoing hysterectomy in the absence of postoperatively evident diagnosis of genital malignancy was carried out. Normal endometrium was the source of bleeding in 24 cases (48.9%) while 11 cases (22.4%) had evidence of endometritis. Endometrial hyperplasia and polyps were present in 12 cases (24.4%). Two cases were found to have malignancy in the surgical specimen, which were not evident on pre-operative endometrial biopsy. However, there was high degree of suspicion of malignancy in these 2 cases based on the endometrial histopathology and ultrasonographic endometrial thickness. By careful correlation of clinical findings, endometrial histopathology and ultrasound measurement of endometrial thickness, most cases with postmenopausal bleeding can be managed conservatively.