Outpatient investigation of postmenopausal bleeding

Reid, PC; Brown, Valerie A.; Fothergill, Diana J

doi:10.1111/j.1471-0528.1993.tb15282.x

Cited by 23 publications

(13 citation statements)

References 7 publications

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“…In the absence of such reporting, the studies were classified as unclear in their reporting of blinding. We classified the reference standard into three groups: those examining hysterectomy specimens or undergoing direct biopsy under hysteroscopic vision (1); those examining specimens from blind Dilatation and Curettage (D & C) under general anesthesia (2); and those obtained by outpatient endometrial biopsy (3). Description of follow up to verify outcome was sought on all women recruited into the study.…”

Section: Methodsmentioning

confidence: 99%

“…Traditionally, dilatation and curettage is routinely used to obtain a histologic diagnosis. Recently, less invasive outpatient diagnostic investigations have been advocated, such as hysteroscopy (2,3) and the measurement of endometrial thickness by pelvic ultrasonography (2)(3)(4)(5)(6). The accuracy of these tests in C Acta Obstet Gynecol Scand 81 (2002) predicting endometrial hyperplasia and endometrial carcinoma is a subject of continuing debate (7)(8)(9)(10)(11)(12).…”

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confidence: 99%

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Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta‐analysis

Gupta

Chien

Voit

et al. 2002

Acta Obstet Gynecol Scand

261

164

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Our aim was to determine the diagnostic accuracy of endometrial thickness measurement by pelvic ultrasonography for predicting endometrial carcinoma and disease (hyperplasia and/or carcinoma) during an investigation of postmenopausal bleeding. We performed a systematic quantitative review of the available published literature, which consisted of online searching the MEDLINE and EMBASE databases (1966-2000) coupled with scanning of bibliography of known primary and review articles. The selection of studies, assessment of study quality, and extraction of data were performed in duplicate under masked conditions. Included in the analyses were 57 studies with 9031 patients. Accuracy data were summarized using likelihood ratios for various cut-off levels of abnormal endometrial thickness. The commonest cut-offs were 4 mm (9 studies) and 5 mm (21 studies), measuring both endometrial layers. None of the nine studies using the < or = 4 mm cut-off level were of good quality. Only four studies (out of the 21) used the < or = 5 mm cut-off level, which employed the best-quality criteria. Using the pooled estimates from these four studies only, a positive test result raised the probability of carcinoma from 14.0% (95% CI 13.3-14.7) to 31.3% (95% CI 26.1-36.3), while a negative test reduced it to 2.5% (95% CI 0.9-6.4). In conclusion, ultrasound measurement of endometrial thickness alone, using the best-quality studies cannot be used to accurately rule. However, a negative result at < or = 5 mm cut-off level measuring both endometrial layers in the presence of endometrial pathology rules out endometrial pathology with good certainty.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta‐analysis

Gupta

Chien

Voit

et al. 2002

Acta Obstet Gynecol Scand

261

164

View full text Add to dashboard Cite

show abstract

“…However the citing of high false-negative rates (10%) of curettage procedures and consequently their limitation of accuracy may be explained by the fact that especially in enlarged uteri less than half the uterine cavity is curetted in 60% of the cases (45). This high rate of false-negative results is a problem which also extends to the other blind endometrial sampling methods (46). If blind endometrial sampling fails to yield sufficient tissue for histologic examination or if the histologic finding does not show evidence of endometrial disease, the clinician should consider the possibility of insufficient sample or of a missed lesion.…”

Section: Discussionmentioning

confidence: 93%

The contribution of hysteroscopy to the detection malignancy in symptomatic postmenopausal women

Liberis

Tsikouras

Zografou

et al. 2010

Minimally Invasive Therapy & Allied Technologies

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Hysteroscopic evaluation of endometrial cavity is widely used in cases of abnormal uterine bleeding. The aim of the present study is to compare the hysteroscopic and histological findings in women suffering from postmenopausal bleeding. Between 1990 and 2009, 425 women aged 47-83 years were included in the study. None of the women had received hormonal therapy or had any malignancy in the past. All women underwent diagnostic hysteroscopy and histologic sampling of the endometrial cavity. Hysteroscopy was successfully completed in 423 women and was suggestive of malignant lesions in 23 cases, which were confirmed histologically. The hysteroscopic findings in three cases were suggestive of atrophic endometrium, atypical hyperplasia and endometrial carcinoma, and the histologic diagnosis confirmed endometrial carcinoma (two cases) and one uterine sarcoma. Hysteroscopy proves to be a safe and effective technique in the diagnosis and management of abnormal uterine bleeding.

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“…Postmenopozal kanamalı hastalarda kanama nedenleri arasında atrofik endometriyum (%60-80), eksojen hormon tedavisi (%15-25), endometriyal hiperplazi (%5-10), endometriyal/servikal polip (%2-12) ve endometriyum kanseri (%10) yer almaktadır. Bunun yanı sıra servisit, atrofik vajinit, vulva, vajen ve serviks kanserleri, uterus sarkomları ve over kanserlerine bağlı kanamalar da görülebilir [14]. Hastamızda öncelikle basit atipisiz endometrial hiperplazi kanama nedeni olarak ortaya çıkmış, hormon tedavisine bir süre cevap veren hastada endometrial polipe bağlı tekrarlayan kanamaların artması nedeniyle malignitenin ekarte edilmesi amacıyla total abdominal histerektomi ve bilateral salpingo-ooferektomi uygulanmıştır.…”

Section: Discussionunclassified

Endometriumda Liesegang halkaları: Olgu sunumu ve literatürün gözden geçirilmesi

Aker¹,

Çiçekli²,

Koç³

et al. 2014

Cumhuriyet Med J

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Outpatient investigation of postmenopausal bleeding

Cited by 23 publications

References 7 publications

Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta‐analysis

Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta‐analysis

The contribution of hysteroscopy to the detection malignancy in symptomatic postmenopausal women

Endometriumda Liesegang halkaları: Olgu sunumu ve literatürün gözden geçirilmesi

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