Transvaginal sonography and progesterone challenge for identifying endometrial pathology in postmenopausal women.
OBJECTIVE
To evaluate the usefulness of transvaginal sonographic (TVS) measurement of endometrial thickness combined with a progesterone challenge test (PCT) for identifying endometrial pathology in postmenopausal women.


METHODS
Two hundred eighty-four postmenopausal women were examined by TVS: 130 asymptomatic women (group A) and 154 with uterine bleeding (group B). Endometrial thickness > 5 mm was considered pathological. All women with abnormal endometrium from group A underwent PCT. All women from group B underwent D&C.


RESULTS
Thirty women with a positive PCT underwent D&C. There was no endometrial cancer. One hundred seven patients from group B had abnormal sonographic and histologic findings: benign (hyperplasia, polyp) or malign (endometrial cancer). There was no cancer in cases with endometrial thickness < or = 6 mm. The sensitivity, specificity and accuracy of TVS for detecting endometrial pathology were 99%, 89% and 96% if the cut-off limit of 5 mm was used.


CONCLUSIONS
TVS combined with PCT is a simple, well-tolerated, safe and reliable method for identifying endometrial pathology in postmenopausal women.
Malinova
M
M
Department of Obstetrics and Gynecology, Medical University, Plovdiv, Bulgaria.
Pehlivanov
B
B
D000328:Adult; D000368:Aged; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging*; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011374:Progesterone; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D011374:Progesterone