Is an endometrial thickness of ≥4 mm on transvaginal ultrasound scan an appropriate threshold for investigation of postmenopausal bleeding?

Russell, Mary; Choudhary, Meenakshi; Roberts, Mark

doi:10.1007/s10397-016-0931-y

Cited by 2 publications

(4 citation statements)

References 12 publications

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“…This finding was similar to study of T. Van Den Bosch et al, Ilan Bruchim et al, Ayman AA. Ewies and M. Russell et al 5,30,24,21 Thus, the present study is in strong agreement with the above studies. 22,33,31 In the present study, it was found that TVS, which is a non-invasive process, measures only the endometrial thickness.…”

Section: Sociation Of Hemoglobin With Histopathologic Findingsupporting

confidence: 93%

“…63 years with the range of 42-80 years. This is in agreement with the studies conducted by HC Van Doorn et al, M. Rusell et al, Bengt Karlsson et al and T. Van Den Bosch et al, where mean age was 62, 62, 64.0 and 59.0 years respectively 14,[21][22][23]. …”

supporting

confidence: 92%

“…18.5-24.9 kg/m 2 , 24% were overweight, 5% were obese and only 4% had BMI <18.5 kg/m 2 which coincides with the study conducted by Viswanathan M et al 2014 However, the study conducted by M. Rusell et al 2016 found 57.8% of patients to be overweight and 39.8% to be obese. 25,21 The study by M. Rusell et al was conducted in United Kingdom, where the average BMI of the woman is high as compared to Indian woman. 21 The study by Viswanathan M et al was conducted in Kerala, India while present study was conducted in Shimla, Himachal Pradesh which is a hilly region with maximum population as rural and agriculture as the main occupation, so the physical activity is more, hence possibly the reason for the difference between the BMI observed in the above studies.…”

Section: Bmi Of the Patientsmentioning

confidence: 99%

“…20 In the present study, endometrial sampling will be done using endometrial Pipelle because it is comparable to the Novak curette in obtaining adequate tissue and is significantly less painful. 21 This pipelle would be inserted into the uterine cavity without dilatation and after insertion, piston is withdrawn.…”

mentioning

confidence: 99%

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Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

Sharma

Dhiman

Sud

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.

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Section: Sociation Of Hemoglobin With Histopathologic Findingsupporting

confidence: 93%

supporting

confidence: 92%

Section: Bmi Of the Patientsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

Sharma

Dhiman

Sud

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Endometrial carcinoma in asymptomatic postmenopausal women with a thickened endometrium

2022

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Introduction. The most common clinical manifestation of endometrial cancer is postmenopausal bleeding, as well as irregular uterine bleeding. Far less often, endometrial cancer may also be present in postmenopausal women without bleeding. The aim of our study was to examine the incidence of endometrial cancer in asymptomatic postmenopausal women with a thickened endometrium. Material and Methods. The research included 251 asymptomatic postmenopausal women with endometrial thickness over 4 mm established by ultrasound. Exploratory curettage was performed in all the patients, followed by histopathological examination of the obtained material. Results. The average age of the respondents was 65.38 ? 26.69 years. The average thickness of the endometrium was 15.68 ? 5.06 mm. Of all the patients, 70.13% presented with benign endometrial disease; endometrial polyps were found in 58.18% and simplex hyperplasia of the endometrium without atypia in 11.95%. Endometrial cancer was found in 1.59% of patients, ovarian cancer metastasis in 0.4%, and endometrial hyperplasia with atypia in 1.59% of patients. All cases of endometrial cancer were diagnosed in patients with endometrial thickness over 11 mm. Conclusion. The approach to asymptomatic women with endometrial hyperplasia should be individual. Exploratory curettage/hysteroscopy should be recommended to patients with endometrial thickness over 11 mm in order to detect and evaluate for endometrial cancer. Asymptomatic women with endometrial thickness of 4 - 10 mm should be further examined, especially in case of associated risk factors or other ultrasound parameters that indicate more serious endometrial pathology.

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Is an endometrial thickness of ≥4 mm on transvaginal ultrasound scan an appropriate threshold for investigation of postmenopausal bleeding?

Cited by 2 publications

References 12 publications

Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

Endometrial carcinoma in asymptomatic postmenopausal women with a thickened endometrium

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