Hysteroscopy: an alternative to dilatation and curettage in the diagnosis of postmenopausal bleeding

Abstract

Data were collected prospectively on 100 women suffering from postmenopausal bleeding who were investigated by hysteroscopy in a 5-month period. Women using hormone replacement therapy were excluded. The most common hysteroscopic finding was atrophy (44%). Other findings were: endometrial cysts (13%), endometrial polyp (12%) and adenocarcinoma (6%). The sample was not representative in 41% of cases and the most frequent histopathological diagnosis was inactive endometrium (14%). Other diagnoses were: inactive endometrium (14%), adenocarcinoma (6%), hyperplasia (7%), endometrial polyp (3%), proliferation (5%) and atrophy (4%), Endometrial sampling was not performed in 13% of the cases. General anaesthesia was not needed and complications were minimal. We support hysteroscopy as a routine alternative to dilatation and curettage in the diagnosis of postmenopausal bleeding.

Comparison of Three Clinical Models for Estimating the Risk of Endometrial Cancer in Post-Menopausal Women with Abnormal Vaginal Bleeding

“…Post-menopausal bleeding that occurs 1 year after the permanent cessation of menstruation is considered abnormal and must be examined (2,3). Abnormal uterine bleeding, which is very common among post-menopausal women, is an important symptom of both benign and malignant diseases in women (4,5). The chance of endome-trial cancer is about 10% in women with post-menopausal bleeding (6).…”