[Postmenopausal gynecologic pathology: 5-years activity at an ambulatory ultrasonography clinic]

The authors examine the role of ultrasonography in the diagnosis of gynecological post-menopausal pathologies and report the activities of the ultrasound out-patient clinic over the past 5 years. Due to the prolonged life expectation of women and consequently the growing request for gynecological examinations, increased importance has been given to the pathologies typical of this age bracket Gynecological exploration if often difficult in elderly patients leading to an increased request for ultrasonography in addition to clinical examination. Transvaginal ultrasonography allows the pelvic structures and endometrial echo-pattern to be examined with greater accuracy. During the period from 1986 to 1991 a total of 405 postmenopausal women were examined using ultrasonography out of a total of 3505 gynecological scans. Scans were performed using a 3.5 MHz suprapubic or endovaginal probe. The most frequent pathology was malignant endometrial carcinoma and the most frequent clinical symptoms was metrorrhagia. In line with findings reported in the literature, the authors underline the vital importance of carefully controlling all perimenopausal women attending an ultrasound out-patient clinic who present risk factors or metrorrhagia using integrated transabdominal and endovaginal diagnosis. The use of the endovaginal probe allows images to be obtained which are otherwise not visible using the transabdominal approach, thus permitting suspect echographic patterns to be identified. Moreover, endometrial evaluation represents an important stage of the examination. It is obvious that the endovaginal approach represents a useful diagnostic technique for screening purposes, especially in high-risk groups for endometrial pathology and ovarian cancer.