title: [Exploration of post-menopausal uterine bleeding. Hysteroscopy-histology correlation in 94 cases].
abstract: BACKGROUND
  Post-menopausal uterine bleeding is the reason for nearly 70% of gynaecological consultations. Because the cause may be a malignant disease, a thorough work-up is necessary to attempt to identify an organic cause.
  
  
  METHODS
  This retrospective study examined 94 cases of post-menopausal bleeding in which both a hysteroscopic and a histological examination were performed in the gynaecology and obstetrics department of the Hedi Chaker University of Sfax from 1 January 2004 to 28 February 2005. We examined correlations between the hysteroscopy and histology findings as well as the causes determined.
  
  
  RESULTS
  By hysteroscopy, we observed atrophic uterine linings in 53 patients (56%), endometrial polyps in 43 patients (45%), endometrial hyperplasia in 23 patients (24%) and myomas in 24 patients (25.5%). This examination suggested malignancy in 12 patients, among 6 of whom endometrial cancer was confirmed histologically. The sensitivity and specificity of hysteroscopy were relatively poor for the diagnosis of endometrial atrophy (about 48.7% and 68.5%), acceptable for endometrial polyps (75% and 86.6%), endometrial hyperplasia (64.7% and 85.5%), and endometrial cancer (60% and 92.7%).
  
  
  CONCLUSIONS
  Hysteroscopy is the most reliable technique for exploration, offering a direct view of the uterine cavity and allowing direct biopsy. Its sensitivity varies according to the indication and diagnosis and is sometimes very good. However, histology remains the reference examination for diagnosis of the cause of post-menopausal uterine bleeding.
authors.affiliation: Service de Gynécologie-obstétrique CHU Hédi-Chaker Sfax Tunisie. Kebaili.Sahbi@yahoo.fr
authors.forename: Sahbi
authors.initials: S
authors.lastname: Kebaili
authors.forename: Mohamel
authors.initials: M
authors.lastname: Dhouib
authors.forename: Kais
authors.initials: K
authors.lastname: Chaabane
authors.forename: Afef
authors.initials: A
authors.lastname: Chtioui
authors.forename: Habib
authors.initials: H
authors.lastname: Amouri
authors.forename: Belhassen
authors.initials: B
authors.lastname: Ben Ayed
authors.forename: Mohamed
authors.initials: M
authors.lastname: Guermazi
mesh_terms: D001284:Atrophy; D004717:Endometrium / Q000473:pathology; D005260:Female; D005831:Genital Diseases, Female / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D009232:Myxoma / Q000473:pathology; D011127:Polyps / Q000473:pathology; D017698:Postmenopause; D002577:Uterine Cervical Diseases / Q000473:pathology; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000473:pathology*; D014594:Uterine Neoplasms / Q000473:pathology*; D014599:Uterus / Q000473:pathology