Prospective comparison of biopsy results from curettage and hysteroscopy in postmenopausal uterine bleeding

Abstract

In postmenopausal women with abnormal uterine bleeding, biopsy by curettage may be not reliable for evaluation of endometrial pathology.

Hysteroscopy as a Valid Tool for Endometrial Pathology in Patients with Postmenopausal Bleeding or Asymptomatic Patients with a Thickened Endometrium: Hysteroscopic and Histological Results

“…Currently, it is suggested that hysteroscopy should always be performed in the case of AUB in postmenopausal women [1,5,6]. In a prospective study, Lee et al [26] compared biopsy results from curettage and hysteroscopy in postmenopausal uterine bleeding and concluded that biopsy by curettage may not be reliable for the evaluation of endometrial pathology. The authors suggest that hysteroscopically guided endometrial biopsy be considered the gold standard for those patients [26].…”

“…In a prospective study, Lee et al [26] compared biopsy results from curettage and hysteroscopy in postmenopausal uterine bleeding and concluded that biopsy by curettage may not be reliable for the evaluation of endometrial pathology. The authors suggest that hysteroscopically guided endometrial biopsy be considered the gold standard for those patients [26]. Office hysteroscopy emerges as an ideal method for the diagnosis and follow-up of patients with endometrial hyperplasia, since it is unlikely to miss a premalignant or malignant lesion in cases where all parts of the cavity are visualized and biopsies from suspected lesions can be performed [17].…”

Evaluation of Endometrial Cytology Prepared with the Becton Dickinson SurePath™ Method: A Pilot Study by the Osaki Study Group

“…On the other hand, Kazandi et al [11] reported problems with Pipelle biopsies in cases involving focal pathologies. Moreover, Lee et al [12] stressed that biopsy by curettage might be not reliable for evaluating endometrial pathology in postmenopausal women with abnormal uterine bleeding. In this study, surgical specimens were used for the histological examinations in 66 cases (54.1%); therefore, we considered that the histological diagnoses we made were reliable.…”

Hysteroscopy and pain: what risk factors should we consider in office hysteroscopy? are there really any?

“…[3][4][5][6] It is now a day considered the gold standard in investigating uterine abnormal bleeding. [7][8][9][10] Examinations and even operations are performed without anesthesia using Office Hysteroscopy (OH) and it is becoming increasingly popular; modern minihysteroscopes are slenderer (outer sheet between 3.1 and 3.6 mm) as opposed to "conventional" hysteroscopes (outer sheet of 5mm diameter) and therefor avoid cervical dilation. Slimmer scopes have been proven to associate to lower pain score at OH and there may be a cutoff around 3.5mm below which reduction in size does not further reduce pain.…”