The aim of our study was to access office hysteroscopy results in postmenopausal patients with thickened endometrium. A retrospective descriptive study was carried out on 245 postmenopausal patients submitted to office hysteroscopy after sonographic diagnosis of thickened endometrium in 20 consecutive months. Women were evaluated for age, hormonal therapy, hysteroscopic findings, procedure duration, complications and associated pain, and histological diagnosis. Patients with and without uterine bleeding were considered separately. Symptomatic patients were older and had longer procedure duration. The most frequent hysteroscopic finding was endometrial polyp in both groups. Pain was subjectively assessed in a numeric scale from 0 to 10 and median value was 4. There were no complications reported. Global neoplasia rate was 2.9% for asymptomatic patients and 16.4% for symptomatic ones (p<0.05). Thickened endometrium with postmenopausal metrorrhagia gave patients a significantly higher risk for neoplasia and hyperplasia.
The aim of our study was to access office hysteroscopy results in postmenopausal patients with thickened endometrium. A retrospective descriptive study was carried out on 245 postmenopausal patients submitted to office hysteroscopy after sonographic diagnosis of thickened endometrium in 20 consecutive months. Women were evaluated for age, hormonal therapy, hysteroscopic findings, procedure duration, complications and associated pain, and histological diagnosis. Patients with and without uterine bleeding were considered separately. Symptomatic patients were older and had longer procedure duration. The most frequent hysteroscopic finding was endometrial polyp in both groups. Pain was subjectively assessed in a numeric scale from 0 to 10 and median value was 4. There were no complications reported. Global neoplasia rate was 2.9% for asymptomatic patients and 16.4% for symptomatic ones (p<0.05). Thickened endometrium with postmenopausal metrorrhagia gave patients a significantly higher risk for neoplasia and hyperplasia.
Background
The aim of this study is to find the effectiveness of hysterosonosalpingography in the diagnosis of the endometrial pathology and in the study of tubal patency.
Method
We have studied 550 cases backwards. The women enrolled came from four departments of our Hospital: Menopause (n = 206), Reproductive Medicine (n = 195), General Gynaecology (n = 125) and Senology − Women on Tamoxifen (n = 24). We have analysed epidemiological data, Transvaginal Sonography and hysterosonosalpingography findings, as well as the conventional Hysterosalpingography, Laparoscopic, Hysteroscopic and histological data. We have looked for the concordance rate between the hysterosonosalpingography and the other diagnostic procedures.
Results
Main findings: Round hyporeflective broad‐based structures representing polyps or submucosal myomas, thin endometrium, floating thin or rigid strips, subseptate uterus, unobstructed tubes, uni or bilateral tubal occlusions. High concordance rate (from 85% to 95%) was verified between the hysterosonosalpingography and the classic diagnostic proceedings.
Conclusion
Hysterosonosalpingography is a good and valuable complement of Transvaginal Sonography in the endometrial study. It makes possible appropriate preoperative triage to hysteroscopy. It may be also a first class exam of screening infertility. The success of this technique led us to include it at the diagnostic protocols in our Hospital.
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