Accuracy of Transvaginal Ultrasonography in Diabetic or Obese Women With Postmenopausal Bleeding

Doorn, Lena C. van; Dijkhuizen, F. P. H. L. J.; Kruitwagen, Roy F.P.M.; Heintz, A. Peter M.; Kooi, G.S.; Mol, Ben Willem J.

doi:10.1097/01.aog.0000136080.55874.7f

Cited by 37 publications

(45 citation statements)

References 15 publications

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“…The pretest probability is approximately 10% for the whole population of patients with PMB, but various clinical characteristics can alter this pretest probability. The probability of endometrial carcinoma in women with PMB rises from 1% in women younger than 50 years to 23.8% in women older than 80 years and the incidence of malignancy is, regardless of age, higher in women with PMB and obesity (18%) or diabetes (21%) as compared to women without one of these risk factors (8.0%) [23]. In obese women with diabetes the incidence is reported to be as high as 29% [23].…”

Section: Diagnosis Of Endometrial Carcinomamentioning

confidence: 99%

Diagnostic Strategies for Postmenopausal Bleeding

Breijer

Timmermans

Doorn

et al. 2010

Obstetrics and Gynecology International

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Postmenopausal bleeding (PMB) is a common clinical problem. Patients with PMB have 10%–15% chance of having endometrial carcinoma and therefore the diagnostic workup is aimed at excluding malignancy. Patient characteristics can alter the probability of having endometrial carcinoma in patients with PMB; in certain groups of patients the incidence has been reported to be as high as 29%. Transvaginal sonography (TVS) is used as a first step in the diagnostic workup, but different authors have come to different conclusions assessing the accuracy of TVS for excluding endometrial carcinoma. Diagnostic procedures obtaining material for histological assessment (e.g., dilatation and curettage, hysteroscopy, and endometrial biopsy) can be more accurate but are also more invasive. The best diagnostic strategy for diagnosing endometrial carcinoma in patients with PMB still remains controversial. Future research should be focussed on achieving a higher accuracy of different diagnostic strategies.

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Section: Diagnosis Of Endometrial Carcinomamentioning

confidence: 99%

Diagnostic Strategies for Postmenopausal Bleeding

Breijer

Timmermans

Doorn

et al. 2010

Obstetrics and Gynecology International

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show abstract

“…This variability has been associated with individual characteristics of the women including age, time since onset of menopause, obesity, hypertension, diabetes mellitus and reproductive factors. [5][6][7][8][9][10] However, guidelines currently used are mainly based on endometrial thickness only and do not systematically take these additional characteristics into account. 3 Inclusion of these individual characteristics may allow for a more refined differentiation of women with the same endometrial thickness.…”

Section: Introductionmentioning

confidence: 99%

Improving the existing diagnostic strategy by accounting for characteristics of the women in the diagnostic work up for postmenopausal bleeding

Opmeer¹,

Doorn

Heintz

et al. 2006

BJOG

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Objectives The aim of this study was to evaluate whether the efficiency of the current diagnostic work up following postmenopausal bleeding could be improved by diagnostic strategies that take into account characteristics of the women in addition to the currently recommended transvaginal measurement of endometrial thickness to determine for subsequent histological assessment.Design Multicenter, prospective cohort study.Setting A university hospital and seven teaching hospitals in the Netherlands.Sample Consecutive women not using hormone replacement therapy, presenting with postmenopausal bleeding.Methods Five hundred and forty women underwent transvaginal sonography, and in case of endometrial thickness (double layer) above 4 mm, subsequent endometrial sampling was performed. Presence of carcinoma was ruled out by the absence of abnormalities in histological specimen or by an uneventful follow up of at least 6 months.Main outcome measures Probability of endometrial carcinoma was estimated by multivariable logistic regression models. For each diagnostic strategy, we calculated diagnostic accuracy (area under receiver operating characteristic curve [AUC]), negative predictive value (NPV) and the number of diagnostic procedures. Conclusion Taking into account the characteristics of the women could increase the efficiency of the diagnostic work up for postmenopausal bleeding.

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“…4,20 In short, a gynecologic examination, including cervical cytology, was performed, followed by transvaginal sonography using high-frequency (5-7.5-MHz) transducers. Endometrial thickness (ET) was measured as a double-layer measurement at the thickest part in the longitudinal plane.…”

Section: Methodsmentioning

confidence: 99%

Value of Cervical Cytology in Diagnosing Endometrial Carcinoma in Women with Postmenopausal Bleeding

et al. 2009

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Accuracy of Transvaginal Ultrasonography in Diabetic or Obese Women With Postmenopausal Bleeding

Abstract: In view of the decreased diagnostic accuracy in diabetic women and obese women, the clinical value of transvaginal endometrial thickness measurement in these women is questionable.

Cited by 37 publications

References 15 publications

Diagnostic Strategies for Postmenopausal Bleeding

Diagnostic Strategies for Postmenopausal Bleeding

Improving the existing diagnostic strategy by accounting for characteristics of the women in the diagnostic work up for postmenopausal bleeding

Value of Cervical Cytology in Diagnosing Endometrial Carcinoma in Women with Postmenopausal Bleeding

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