Hysteroscopic assessment of postmenopausal endometrial thickening.
BACKGROUND
Endometrial thickness is measured by transvaginal sonography and thickening indicates an increased risk of malignancy or other pathology (hyperplasia or polyp) in the postmenopausal period. The main screening methods for the uterine cavity are dilatation and curettage, and hysteroscopy. We sought to correlate hysteroscopic and pathological findings in asymptomatic postmenopausal women with sonographically thickened endometrium (> 5 mm) in this study.


METHODS
This retrospective cross-sectional study involved case records of 197 women who have thickened (> 5 mm) endometrium in the postmenopausal period. All these women underwent hysteroscopy with diagnostic dilatation and curettage between January 2012 and January 2013 at the Bursa Zübeyde Hanım Maternity Hospital. Sensitivity, specificity, positive, negative predictive values and p value of hysteroscopy were calculated. Dilatation and curettage was set as the gold standard.


RESULTS
For the evaluation of postmenopausal thickened endometrium, hysteroscopy revealed sensitivity, specificity, positive predictive value and negative predictive value as 76.4%, 76.9%, 73.1%, 79.8%, respectively.


CONCLUSIONS
Hysteroscopy is a fast and accurate technique in evaluation of the intrauterine space occupying lesions (polyp, fibroid) but only moderate for endometrial hyperplasia. Hysteroscopic view combined with direct biopsy could be a gold standard for endometrial assessment.
Department of Gynecology and Obstetrics, Medical Park Uşak Hospital, Uşak, Turkey.
Engin
E
Korkmazer
Department of Gynecology and Obstetrics, Medical Park Uşak Hospital, Uşak, Turkey.
Neşe
N
Solak
Department of Gynecology and Obstetrics, Bursa Şevket Yılmaz Teaching Hospital, Bursa, Turkey.
Emin
E
Üstünyurt
dilatation and curettage; endometrial hyperplasia; hysteroscopy; menopause