Hysteroscopic evaluation of menopausal women with endometrial thickness of 4 mm or more.
OBJECTIVE
To assess the diagnostic and operative potential of hysteroscopy in postmenopausal patients selected by ultrasound criteria.


METHODS
Cohort study (Canadian Task Force classification II-2).


METHODS
Outpatient ultrasound and hysteroscopy department of a university-affiliated hospital.


METHODS
One hundred fifty-five postmenopausal women with endometrial thickness of 4 mm or more by ultrasound, in menopause for at least 1 year, with or without menopausal complaints.


METHODS
Transvaginal ultrasound and office hysteroscopy with eye-directed biopsy specimens using a 5-mm, continuous-flow, operative hysteroscope.


RESULTS
Of the 155 women, 129 (83%) were asymptomatic (irregular bleeding). Hysteroscopy showed endometrial pathology in 28% of asymptomatic patients (23 polyps, 5 cases of hyperplasia, 8 submucous myomata) and 76% of symptomatic women (13 polyps, 6 hyperplasia, 1 submucous myoma). Hysteroscopic results compared with histologic diagnosis showed a positive predictive value equal to 97. 1% and 95% in asymptomatic and symptomatic women, respectively, and a negative predictive value equal to 100% in both groups.


CONCLUSIONS
Office hysteroscopy with endometrial biopsy samples has a diagnostic and operative role in postmenopausal patients selected based on endometrial thickness on ultrasound, in view of the high prevalence of endometrial pathology in both symptomatic and asymptomatic women.
Loizzi
V
V
II Clinica Ostetrica e Ginecologica Policlinico, Piazza Giulio Cesare 11, 70125 Bari, Italy.
Bettocchi
S
S
Vimercati
A
A
Ceci
O
O
Rossi
C
C
Marello
F
F
Greco
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D014463:Ultrasonography