[Post-menopausal metrorrhagia: endometrial ultrasonic aspects]

Main causes of uterine post-menopausal bleeding are estrogenic substitutive therapy, ipo/atrophy, hyperplasia, carcinoma of endometrium and sarcoma. To evaluate the real usefulness of echotomography in these conditions, 128 patients in post-menopause (end of menstrual cycles from over an year) with at least one uterine bleeding were considered. The patients were submitted to pelvic ultrasonography in order to study uterine and ovarian morphology and, in particular, to examine endometrial echopattern. Endometrial reliefs were classified into 4 groups of echopattern and put in comparison with histopathology. From this comparison a well defined role of echotomography in the study of post-menopausal bleeding is evidenced: in cases of "abnormal echopattern" the probability of endometrial pathology is elevated (83.3%), with a good "sensibility" but without a so good "specificity" of ultrasounds: therefore its "subsidiary" but "necessary" role in the diagnosis of climateric uterine bleeding is emphasized.