Comparison of transvaginal ultrasound, hysteroscopy, and dilatation and curettage in the diagnosis of abnormal vaginal bleeding and intrauterine pathology in perimenopausal and postmenopausal women.
OBJECTIVE
To compare transvaginal ultrasound, hysteroscopy, and dilation and curettage (D&C) in the evaluation of women with perimenopausal and postmenopausal bleeding.


METHODS
Descriptive study (Canadian Task Force classification II-1).


METHODS
Seven outpatient clinics.


METHODS
One thousand two hundred eighty-six women.


METHODS
Transvaginal ultrasound, hysteroscopy, and D&C.


RESULTS
Of our patient population, 29 (2.26%) had a histologic diagnosis of endometrial carcinoma; in 2 of them (7.14%) endometrial thickness was 5 mm or less. In 10 women (34.5%), endometrial carcinoma was missed by hysteroscopy (sensitivity 65.52%, specificity 99.92%). Complication rate of D&C was 1.4%.


CONCLUSIONS
In women with perimenopausal and postmenopausal bleeding neither transvaginal ultrasound nor hysteroscopy as a single diagnostic tool is suitable to rule out endometrial cancer.
Deckardt
R
R
Gynaekologische Praxisklinik, Helene-Weber-Allee 19, Munich 80637, Germany.
Lueken
R P
RP
Gallinat
A
A
Möller
C P
CP
Busche
D
D
Nugent
W
W
Salfelder
A
A
Dohnke
H
H
Hoffmeister
U
U
Dewitt
E
E
Hennefründ
J
J
Hasskamp
T
T
Krichbaum
M
M
Maucher
A
A
Auweiler
U
U
Brökelmann
J
J
Saks
M
M
Füger
T
T
D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000175:diagnosis; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis; D014463:Ultrasonography; D014591:Uterine Diseases / Q000175:diagnosis*; D014592:Uterine Hemorrhage / Q000175:diagnosis*; D014621:Vagina / Q000000981:diagnostic imaging*