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Transvaginal sonography and hysteroscopy in postmenopausal bleeding
B Cacciatore1, T Ramsay, P Lehtovirta
1Department I of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
Acta Obstetricia Et Gynecologica Scandinavica
|May 1, 1994
Summary
Transvaginal sonography effectively detects most endometrial pathologies in postmenopausal bleeding, serving as a valuable initial diagnostic tool. Hysteroscopy offers higher sensitivity for specific conditions like polyps and cancer.
Area of Science:
- Gynecology
- Diagnostic Imaging
- Pathology
Background:
- Atypical postmenopausal bleeding requires accurate diagnosis to rule out significant endometrial pathology.
- Transvaginal sonography and hysteroscopy are key imaging modalities, but their comparative diagnostic utility needs clarification.
Purpose of the Study:
- To compare the diagnostic accuracy of transvaginal sonography and hysteroscopy against histological findings in women with atypical postmenopausal bleeding.
Main Methods:
- Retrospective analysis of 45 women with atypical postmenopausal bleeding.
- Comparison of transvaginal sonography and hysteroscopy findings with dilatation and curettage (D&C) histological diagnoses.
- Calculation of sensitivity, specificity, and predictive values for both imaging techniques.
Main Results:
- Histological diagnoses included atrophy, hormonal effects, endometrial polyps, and adenocarcinoma.
- Hysteroscopy demonstrated higher detection rates for polyps and carcinoma compared to transvaginal sonography.
- Transvaginal sonography showed high sensitivity (95.7%) and specificity (45.5%) for endometrial pathology when endometrial thickness was >= 5 mm.
Conclusions:
- Transvaginal sonography is a highly sensitive initial diagnostic step for endometrial pathology in postmenopausal bleeding.
- Hysteroscopy provides superior detection of specific pathologies like polyps and cancer.
- Endometrial thickness >= 5 mm is a significant indicator for potential endometrial pathology.