Endometrial Thickness in 1,500 Asymptomatic Postmenopausal Women Not on Hormone Replacement Therapy

Hartman, A.; Wolfman, Wendy; Nayot, Dan; Hartman, Michael

doi:10.1159/000347064

Cited by 17 publications

(17 citation statements)

References 29 publications

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“…Out of the 570 cases, we selected 320 which satisfied the inclusion criteria. These women either complained of postmenopausal bleeding or their endometrial thickness was >5 mm as measured by transvaginal ultrasound [8]. Menopause was defined as spontaneous cessation of menses for ≥12 months.…”

Section: Methodsmentioning

confidence: 99%

“…The first test applied in these patients is transvaginal ultrasound, which allows measuring endometrial thickness. However, hysteroscopy is believed to be the first-line diagnostic tool for the recognition of endometrial pathologies [1,6,7,8]. Asymptomatic postmenopausal women with a thickened endometrium found by ultrasound are also subjected to hysteroscopy, since the diagnostic value of endometrial thickness has not yet been documented [6,9].…”

Section: Introductionmentioning

confidence: 99%

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Hysteroscopy as a Valid Tool for Endometrial Pathology in Patients with Postmenopausal Bleeding or Asymptomatic Patients with a Thickened Endometrium: Hysteroscopic and Histological Results

Loiacono

Trojano

Gaudio

et al. 2015

Gynecol Obstet Invest

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Objective: This study compares hysteroscopic and histopathological results in postmenopausal women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium. Materials and Methods: This is a retrospective study of 570 cases hysteroscopically examined between January 2008 and July 2012. The patients were followed up at the Istituto Tumori ‘Giovanni Paolo II', Bari, Italy. Results: A total of 320 of the 570 cases were selected. The inclusion criteria were transvaginal ultrasound, hysteroscopy and endometrial biopsy. In the AUB group, if the hysteroscopy results were normal, a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100, 95, 71 and 100%, respectively, were achieved, while in the asymptomatic group these values were 100, 97, 90 and 100%, respectively. For both the group with polyps and that with myomas, the sensitivity, specificity, PPV and NPV were 100%. For endometrial hyperplasia, hysteroscopy showed a sensitivity, specificity, PPV and NPV of 81, 96, 87 and 93%, respectively, in the AUB group, while in the asymptomatic group, the sensitivity was 60%, the specificity and PPV were 100%, and the NPV was 98%. The sensitivity of hysteroscopy for endometrial cancer was 63%, the specificity 97%, the PPV 77%, and the NPV 95%. Conclusions: In postmenopausal women with a thickened endometrium with or without AUB, hysteroscopy allows for an accurate diagnosis in benign endometrial pathology. Hysteroscopy also allows directed biopsies of suspicious lesions, which is useful in malignant endometrial pathology.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hysteroscopy as a Valid Tool for Endometrial Pathology in Patients with Postmenopausal Bleeding or Asymptomatic Patients with a Thickened Endometrium: Hysteroscopic and Histological Results

Loiacono

Trojano

Gaudio

et al. 2015

Gynecol Obstet Invest

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“…with more than 20 years of experience in hysteroscopic surgery to avoid interoperator variability. As initial follow-up, all patients were subjected to TVUS and SIS, and, in the case of subjects with endometrial thickness greater than 5 mm, which is suspicious for polyp [17], even to a consented outpatient diagnostic hysteroscopy by well-trained sonographers and clinicians (S.R. and C.B.…”

Section: Methodsmentioning

confidence: 99%

Recurrence of Endometrial Polyps

Paradisi

Rossi

Scifo

et al. 2014

Gynecol Obstet Invest

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Aims: To estimate the recurrence rate of patients with endometrial polyps and to evaluate whether the recurrence can be correlated with the histopathologic features of the polyp. Methods: Two hundred and eighty-two women with endometrial polyps in both pre- or postmenopausal period and suffering from abnormal uterine bleeding or not were treated by resectoscopic surgery in a tertiary university hospital and were subsequently followed to check for polyp recurrence. Results: Polyp recurrence rate after hysteroscopic surgery and correlation between recurrence and main demographic, hysteroscopic and histopathologic characteristics were analyzed. During mean ± SD follow-up period of 26.3 ± 19.7 months, the overall recurrence rate was high (13.3%) and did not vary (p = NS) with age, parity, weight or other demographic characteristics of the patients or with the hysteroscopic appearance. On the contrary, the histopathologic features showed significant differences between patients with and without polyp recurrence. Recurrence rate was higher (p < 0.001) in women with histopathologically hyperplastic polyps without atypia and lower (p < 0.001) in women with benign polyps. Conclusion: The study shows that after resectoscopic polypectomy, the recurrence rate of endometrial polyps is high (13.3%). Moreover, the hyperplastic polyps without atypia recur more frequently than benign ones.

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“…However, a significant group, 6.7%, had an endometrial lining suspicious for polyp. These women had a significant increase in mean age and ET [5].…”

Section: Resultsmentioning

confidence: 92%

Asymptomatic postmenopausal women with sonographically thickened endometrium. What do we do?

Sathiyathasan¹,

Jeyanthan²,

Khoo³

2013

OJOG

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Background: A thickened endometrium in the postmenopausal patient is a common reason for referral to gynaecology rapid access clinics under the cancer targets wait. This can often be an incidental finding in the asymptomatic patient. Investigation of this can be invasive, uncomfortable and carries significant surgical risk. Aims: This paper aims to summarise all the recent literature to see if there is any clear consensus on who should be further investigated in this select group of patients. Methods: Systematic literature review. Results: The studies varied greatly on the need for further investigation in asymptomatic women with endometrial thickness greater than 11 mm, with some deciding on careful case selection for further investigation, and others investigating every patient. The treatment of asymptomatic patients with endometrium classified as thickened, yet under 11 mm and no symptoms again varied in case selection and further investigation. Endometrial polyps were mentioned in 1 paper, suggesting that asymptomatic polyps need not be removed, which is contrary to current clinical practice. Conclusion: There is no overall opinion as to the exact treatment of women with thickened endometrium. Women should be carefully triaged and all other factors taken into account before further investigation are instigated.

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Endometrial Thickness in 1,500 Asymptomatic Postmenopausal Women Not on Hormone Replacement Therapy

Cited by 17 publications

References 29 publications

Hysteroscopy as a Valid Tool for Endometrial Pathology in Patients with Postmenopausal Bleeding or Asymptomatic Patients with a Thickened Endometrium: Hysteroscopic and Histological Results

Hysteroscopy as a Valid Tool for Endometrial Pathology in Patients with Postmenopausal Bleeding or Asymptomatic Patients with a Thickened Endometrium: Hysteroscopic and Histological Results

Recurrence of Endometrial Polyps

Asymptomatic postmenopausal women with sonographically thickened endometrium. What do we do?

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