[Transvaginal sonography as a screening method for the identification of patients at risk of postmenopausal endometrial pathology].
Starting from the anatomopathological assumption that endometrial thickness in postmenopausal women never exceeds 3 mm, and in view of the reliability of measurements made using an echographic probe, the authors evaluated the value of transvaginosonography (TVS) as a mass screening method for postmenopausal endometrial pathologies. A group of 74 patients were examined who were recruited from those attending the out-patient menopause clinic. All subjects conformed to the following admission criteria: amenorrhea for the past two years; absence of oestroprogestin therapy for at least six months; absence of vaginal blood loss. A 5 MHz probe was used to measure maximum endometrial thickness on the longitudinal plane; values were divided by two if the surfaces were adjacent. Patients were monitored according to the following protocol: endometrial thickness under 1 mm control every 12 months; thickness between 1-3 mm--control every 3 months; thickness equal to or over 4 mm--hysteroscopy, targeted biopsy, possible scraping and TVS control after 3 months. The group was subdivided as follows: 65 patients (87.8%) were without risk; 3 patients (4%) belonged to the intermediate risk group; 6 patients (8.2%) belonged to the high risk group. Of the latter, 4 revealed an endometrial polyp, one presented uterine polymyomatosis and one a proliferative-type endometrium. The authors' experience is still limited but the absence of false positives encourages them to continue their research using this simple and well tolerated method. It might represent a valid alternative to hysteroscopy as a screening method in the asymptomatic population at risk for endometrial carcinoma.
Zacchi
V
V
Divisione Ostetricia Ginecologica, Ospedale Niguarda Ca' Granda, Milano.
Zini
R
R
Canino
A
A
D001706:Biopsy; D003937:Diagnosis, Differential; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging*; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging*; D004717:Endometrium / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008403:Mass Screening; D008722:Methods; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors; D014463:Ultrasonography; D014621:Vagina