Screening transvaginal ultrasonography of postmenopausal women in a private office setting

The objective of this study was to determine the value of screening transvaginal ultrasonography for the evaluation of endometrial or ovarian abnormalities in asymptomatic postmenopausal women in a private gynecology office at the time of yearly examination.

All postmenopausal women who were seen for yearly examination between June 1, 1991, and June 1, 1993, underwent screening transvaginal ultrasonographic examinations that I performed. Women who had any pelvic symptoms or who were premenopausal were excluded from the study group.

During the 24 months of this study 478 women were screened. One case of early ovarian carcinoma was diagnosed, one case of superficial adenocarcinoma of the endometrium was discovered, and 28 other ovarian cysts were seen. All women with cystic changes in the ovaries underwent testing for serum CA 125 levels, and follow-up ultrasonography was done at 1 and 3 months. Ovaries were removed if the CA 125 level was elevated, if the cyst became larger, or if the patient desired. No additional ovarian carcinomas were found in those women who had cysts discovered on ultrasonography and who subsequently had the ovaries removed.

Screening transvaginal ultrasonography examinations were well received by all patients, there was no significant associated discomfort, the scans required minimal time, and a significant number of abnormalities were discovered, including two early carcinomas. I believe that when transvaginal ultrasonography is available in an office setting, where it can be performed at no or very low cost, routine screening of postmenopausal women is a valuable addition to the yearly examination.