The value of transvaginal sonography in detecting endometrial pathologies in postmenopausal women with or without...

The aim of this study was to estimate the incidence of endometrial pathologies and compare the findings in postmenopausal women with or without bleeding who had endometrial thickness ≥5 mm.

Between January 2010 and December 2012 medical records of postmenopausal patients who underwent endometrial biopsy were reviewed retrospectively. 91 patients who presented with postmenopausal bleeding (Group A) with an endometrial thickness equal to or greater than 5 mm and 44 patients with an incidental finding of increased endometrial thickness (≥5 mm) on ultrasound without bleeding (Group B) were included in the study.

The mean endometrial thickness of patients in group A (9.3±4.6) was significantly lower than women in group B (11±4.6). Seven (7.7%) cases of endometrial hyperplasia and 6 (6.6%) cases of endometrial carcinoma were detected in women with bleeding, 2 (4.5%) cases of endometrial hyperplasia and no cases of endometrial carcinoma were diagnosed in group B women. The prevalence of endometrial carcinoma associated with endometrial thickness in group A women whereas we cannot see this relation in group B women. The mean endometrial thickness was highest in women with the histopathologic diagnosis of polyps in this group.

In postmenopausal women with bleeding, the risk of endometrial carcinoma increases with increasing endometrial thickness; however, the use of endometrial thickness as a screening test for endometrial carcinoma may not be effective in women without bleeding. 6.5 mm cut-off seems to be acceptable thickness for polyp detection in postmenopausal women with bleeding.