title: Hysteroscopic evaluation of menopausal women with endometrial thickness of 4 mm or more.
abstract: 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.
authors.affiliation: II Clinica Ostetrica e Ginecologica Policlinico, Piazza Giulio Cesare 11, 70125 Bari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Loizzi
authors.forename: S
authors.initials: S
authors.lastname: Bettocchi
authors.forename: A
authors.initials: A
authors.lastname: Vimercati
authors.forename: O
authors.initials: O
authors.lastname: Ceci
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: F
authors.initials: F
authors.lastname: Marello
authors.forename: P
authors.initials: P
authors.lastname: Greco
mesh_terms: 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