Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding ultrasound is used to categorize women as being at low or high risk of endometrial cancer, the result of the ultrasound examination being the basis for further management. In women with abnormal vaginal bleeding before menopause the role of ultrasound is less clear, because some common causes of abnormal vaginal bleeding before menopause cannot be diagnosed with ultrasound, e.g. infection, dysfunctional bleeding or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may sometimes be helpful also in women with abnormal vaginal bleeding before menopause. In this chapter ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas including submucuous myomas, and leiomyosarcoma will be presented and ultrasound based triage of women with postmenopusal bleeding described. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2
AbstractTransvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding ultrasound is used to categorize women as being at low or high risk of endometrial cancer, the result of the ultrasound examination being the basis for further management. In women with abnormal vaginal bleeding before menopause the role of ultrasound is less clear, because some common causes of abnormal vaginal bleeding before menopause cannot be diagnosed with ultrasound, e.g. infection, dysfunctional bleeding or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may sometimes be helpful also in women with abnormal vaginal bleeding before menopause. In this chapter ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas including submucuous myomas, and leiomyosarcoma will be presented and ultrasound based triage of women with postmenopusal bleeding described.