Hysteroscopic evaluation of menopausal patients with sonographically atrophic endometrium.
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.
Marello
F
F
II Clinica Ostetrica e Ginecologica Policlinico, Piazza Giulio Cesare 11, 70125 Bari, Italy.
Bettocchi
S
S
Greco
P
P
Ceci
O
O
Vimercati
A
A
Di Venere
R
R
Loverro
G
G
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