Importance of transvaginal ultrasonography before endometrial sampling in asymptomatic postmenopausal patients

Endometrial cancer is the most common gynecologic cancer. Transvaginal ultrasonography (TV USG) is considered to be the first-line diagnostic method for the evaluation of endometrial cancer. 213 asymptomatic postmenopausal patients (192 benign, 21 patients malignant endometrial findings after endometrial sampling) who underwent evaluation with gray-scale TV USG at maximum 48h before endometrial sampling were included. Except for hypertension (P=0.004) and endometrial thickness (P=0.003), there was no significant difference in the demographic data, endometrial fluid and endometrial cystic areas detected on TV USG between the groups. A cut-off value of 8.35mm for endometrial thickness yielded 98.05% positive predictive value with 95% CI. If the endometrial thickness is ≥8.35mm at TV USG performing endometrial curettage will be reasonable not to wait until 11mm and endometrial sampling is not required if TV USG shows fluid and cystic areas in the endometrial cavity.