title: Hysteroscopic evaluation of menopausal patients with sonographically atrophic endometrium.
abstract: OBJECTIVE
  To assess the diagnostic and operative potential of hysteroscopy in postmenopausal patients selected by ultrasound criteria.
  
  
  METHODS
  Prospective evaluation (Canadian Task Force classification II-2).
  
  
  METHODS
  Outpatient ultrasound and hysteroscopy department of a university-affiliated hospital.
  
  
  METHODS
  Two hundred twelve women with an endometrial thickness less than 4 mm on ultrasound and in menopause for at least 1 year.
  
  
  METHODS
  Transvaginal ultrasound and office hysteroscopy, with eye-directed biopsy specimens obtained with a 5-mm, continuous-flow operative hysteroscope, and performed without anesthesia.
  
  
  RESULTS
  Only 13 (6%) patients were symptomatic (irregular bleeding). Hysteroscopic diagnosis of endometrial polyps in three women (23%) was confirmed by histology. In the remaining 199 (94%) asymptomatic patients with atrophic endometrium on ultrasound, hysteroscopy showed an endometrial pathology in 10% (16 polyps, 4 submucous myomas); in one patient histologic evaluation disclosed focal adenocarcinoma in an endometrial polyp.
  
  
  CONCLUSIONS
  Hysteroscopy allows a proper histologic diagnosis, even in asymptomatic postmenopausal women with atrophic endometrium on ultrasound.
authors.affiliation: II Clinica Ostetrica e Ginecologica Policlinico, Piazza Giulio Cesare 11, 70125 Bari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Marello
authors.forename: S
authors.initials: S
authors.lastname: Bettocchi
authors.forename: P
authors.initials: P
authors.lastname: Greco
authors.forename: O
authors.initials: O
authors.lastname: Ceci
authors.forename: A
authors.initials: A
authors.lastname: Vimercati
authors.forename: R
authors.initials: R
authors.lastname: Di Venere
authors.forename: G
authors.initials: G
authors.lastname: Loverro
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D016889:Endometrial Neoplasms / Q000473:pathology; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D011127:Polyps / Q000473:pathology; D011446:Prospective Studies; D014463:Ultrasonography