Hysteroscopy in Postmenopausal Bleeding

Abstract

The purpose of the present study was to evaluate the utility of hysteroscopy as a diagnostic tool in cases of postmenopausal bleeding, The study includes 42 cases presenting with postmenopausal bleeding on which hysterscopy was performed using rigid hysteroscope (CIRCON) with glycine 1.5% as the distension medium. In 17 of the 42 cases positive hysteroscopic findings were noted which included 2 cases of endometrial carcinoma, 2 cases of postmenopausal endometritis, 4 cases of endometrial polyp, 5 cases of endometrial hyperplasia, 1 case of submucous myoma and 3 cases of endocervical polyp whereas normal postmenopausal endometrium was noticed in rest of the 25 cases. Endometrial biopsy was done in all these cases so that the hysteroscopic findings could be corroborated with tissue diagnosis. Hysteroscopy along with directed endometrial biopsy proved to be a useful diagnostic aid in cases of postmenopausal bleeding.

Hysteroscopic Findings in Postmenopausal Bleeding and its Correlation with Histopathology: Does Clinical Experience Matter?

“…6 The availability of hysteroscopy for guiding endometrial biopsy leads to almost 100% accuracy in the diagnosis of endometrial neoplasia and its precursors. 7 The use of blind endometrial sampling can be inaccurate in diagnosing some pathologies, especially in cases of localized pathologies such as endometrial polyps, submucous myomas, and focal endometrial abnormalities including adenocarcinoma 8 PMB is a common clinical condition with an incidence of 10% immediately after menopause. 9 the incidence of bleeding appears to decrease over time as reported by Astrup and Olivarius who found that the incidence of bleeding fell from 409/1000 person-years immediately in the first year of menopause to 42/1000 person-years more than three years after menopause.…”

“…diabetes, obesity, nulliparous, with late onset of menopause) 4 Hysteroscopy is a valuable diagnostic tool with high specificity for diagnosing intra-cavitary lesions and endometrial conditions in abnormal uterine bleeding (AUB) evaluation including PMB. 5 The aim of this study was to evaluate different hysteroscopic findings in women with PMB and its correlation with histopathological findings in early and late postmenopausal women. Another aim was to evaluate the impact of years of clinical experience on accuracy of hysteroscopic diagnosis of endometrial cancer…”

Evaluation of Hysteroscopic Findings and Histopathologic Report of Endometrium in Postmenopausal Bleeding

“…3 So, the combination of hysteroscopy with hysteroscopy directed biopsy potentially serves a diagnostic and therapeutic purpose. 9,10,11 Several studies had been done for evaluation of endometrium in postmenopausal bleeding and most of the studies showed high sensitivity, specificity, positive predictive value, negative predictive value of hysteroscopy for diagnosis of endometrial pathology.…”