Clinical and Sonographic Evaluation of Postmenopausal Bleeding (PMB) Followed by Diagnostic and/or Therapeutic Hysteroscopy and Guided Biopsy in Jordanian Hospitals

Omar, Abu-Azzam; Seham, Abufraijeh; Al-Kharabsheh, Ahlam Mahmoud; Alshara, Emad; Sindiani, Amer; Omar, Hamdan; Ghoul, Imene; Alrawashdeh, Hamzeh Mohammad

doi:10.3390/medicina56040147

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Transvaginal Ultrasound or endometrial biopsy is proposed as an initial investigation in females with postmenopausal bleeding. 5,6 Post-menopausal bleeding was initially assessed by dilatation and curettage (D & C) but measurement of endometrial thickness (ET) by transvaginal ultrasound (TVS) has replaced D & C as the first step in investigating women with PMB. TVS is noninvasive, easily available, comparatively painless & can also detect other pathologies like ovarian cysts & fibroids.…”

Section: Introductionmentioning

confidence: 99%

Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women

Bibi,

Majeed,

Mushtaq

et al. 2023

JRMC

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Objective: Dilatation and curettage have been replaced by ultrasound measurement of uterine endometrial thickness (ET) especially by Transvaginal ultrasound (TVS) as a first step in the workup of women with postmenopausal bleeding for many years. Still, there is no unanimity for endometrial thickness cut-off value to define abnormality. We used an endometrial thickness of 4mm as a cut-off value in this study. Methods: This cross-sectional validation study included 120 patients who presented with postmenopausal bleeding in OPD of POF hospital from 01-12-2017 to 1-06-2018.TVS measured endometrial thickness ≥4mm was assumed positive for malignancy and ˂ 4 mm was taken negative for malignancy. The TVS findings of patients were compared with the histopathology report of endometrial sampling, which was performed in OPD by manual vacuum aspirator (MVA). Histopathology report was taken as a reference standard to confirm or refute the diagnosis of transvaginal ultrasound. Results: On TVS, 54 patients had ≥ 4mm endometrial thickness (taken positive for malignancy) while 66 patients had <4 mm endometrial thickness (taken negative for malignancy). Histopathology of the endometrium (reference standard) revealed that 47 (39.17%) patients had malignancy and 73(60.83%) patients did not have malignancy. The reliability of transvaginal ultrasound (TVS) using 4mm cut-off point ET in detecting endometrial malignancy in patients presenting with uterine bleeding after menopause, keeping histopathological findings as a reference standard showed 89.36% sensitivity, 83.56%, specificity, 92.42% negative predictive value and 77.78% positive predictive value & 85.83% accuracy rate. Conclusion: We concluded that there was a low probability of endometrial malignancy in women with ˂ 4 mm transvaginal ultrasound (TVS)measured endometrial thickness (ET).TVS may replace invasive endometrial sampling in cases of postmenopausal bleeding with ˂ 4mm ET.

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Section: Introductionmentioning

confidence: 99%

Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women

Bibi,

Majeed,

Mushtaq

et al. 2023

JRMC

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“…Nustatant endometriumo patologiją pacientėms, besiskundžiančioms pomenopauziniu kraujavimu, sonohisterografijos jautrumas buvo 86,5 proc., specifiškumas -91,1 procento [12]. Vis dėlto vienas iš tinkamiausių metodų tirti gimdos ertmę moterims, esant endometriumo sustorėjimui, yra minimaliai invazinė procedūra -histeroskopija [13]. Vertinama, kad tai saugi, jautri diagnostinė procedūra, kurios komplikacijų rizika <1 procento [14].…”

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Pomenopauzinis Kraujavimas Iš Gimdos: Klasifikacija, Priežastys, Diagnostika, Gydymas

Skvarnavičiūtė¹

2021

Health Sciences

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Pomenopauzinis kraujavimas – tai kraujavimas iš gimdos, atsirandantis praėjus mažiausiai vieneriems metams nuo menopauzės pradžios. Tai dažna medicininė problema, tiesiogiai veikianti moterų gyvenimo kokybę, sveikatos priežiūros išteklių panaudojimą ir išlaidas. Kraujavimas po menopauzės yra viena iš dažniausių priežasčių, dėl kurių moterys kreipiasi į gydytojus akušerius ginekologus. Pomenopauzinio kraujavimo iš gimdos gydymas priklauso nuo diagnozuotos kraujavimo priežasties ir turėtų būti pritaikytas individualiai, atsižvelgiant į pacientės sveikatos būklę, tikslus. Pomenopauzinis kraujavimas gali būti pirmasis endometriumo vėžio požymis, todėl klinikinis kraujavimo po menopauzės tyrimas reikalingas greito ir efektyvaus įvertinimo, kad būtų diagnozuota ir gydoma endometriumo karcinoma ar endometriumo hiperplazija. Tyrimo tikslas – išsiaiškinti pomenopauzinio kraujavimo iš gimdos klasifikaciją, priežastis, diagnostiką ir gydymą. Metodika. Literatūra buvo rinkta naudojant Pubmed duomenų bazę. Išvados. Kraujavimas pomenopauziniu laikotarpiu yra dažna kreipimosi į gydytojus ginekologus priežastis. Kraujavimas iš gimdos turėtų būti įvertintas remiantis PALM – COEIN klasifikacija. Šiuo metu histeroskopija su atliekamomis biopsijomis yra auksinis standartas diagnozuoti endometriumo anomalijas. Gydymas priklauso nuo kraujavimo etiologijos, taikomas individualiai, atsižvelgiant į pacientės sveikatos būklę, tikslus.

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A mini-review of office hysteroscopic techniques for endometrial tissue sampling in postmenopausal bleeding

Haimovich

Tanvir

2021

J Mid-life Health

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Postmenopausal bleeding (PMB) is a common cause for a gynecological visit. Endometrial cancer risk varies from 3% to 25% in women with PMB. There is a significant concern of malignancy of the endometrium and the endocervical canal by a physician in postmenopausal women, and hence, most prefer operating room hysteroscopies with dilation and curettage (D & C) compared to in-office procedures. With increased availablility of miniaturized instruments such as mini- resectoscope and tissue removal systems, there is high likelihood of blind D & C being replaced by hysteroscopic- guided targetted biopsy or visual D & C. The cost-effectiveness of office hysteroscopy is also well demonstrated. In December 2020, an electronic search was performed of PubMed, MEDLINE, and Cochrane Library to look for articles on office hysteroscopic biopsy techniques in postmenopausal women from 2010 to 2020. Relevant studies were included where various office hysteroscopic techniques are used for endometrial sampling in PMB. Studies with 5 Fr scissors, biopsy forceps, crocodile forceps, cup forceps, bipolar electrode, in-office tissue removal system (morcellator), flexible hysteroscope, and mini-resectoscope were included. Standard reference was used as an adequate endometrial sample for histology. The objective of this review is to explore the current evidence on different office hysteroscopic techniques available for endometrial tissue sampling in PMB. Research Question: What are the different available in - office hysteroscopy techniques for obtaining endometrial biopsy? Clinical Importance: Understanding the adequacy of an endometrial tissue sample obtained by different in - office hysteroscopy techniques and their accuracy by histology.

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Clinical and Sonographic Evaluation of Postmenopausal Bleeding (PMB) Followed by Diagnostic and/or Therapeutic Hysteroscopy and Guided Biopsy in Jordanian Hospitals

Cited by 3 publications

References 11 publications

Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women

Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women

Pomenopauzinis Kraujavimas Iš Gimdos: Klasifikacija, Priežastys, Diagnostika, Gydymas

A mini-review of office hysteroscopic techniques for endometrial tissue sampling in postmenopausal bleeding

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