TRANSVAGINAL SONOGRAPHY AND HYSTEROSCOPY IN WOMEN WITH POSTMENOPAUSALBLEEDING

Objective: To make a prospective comparison between endometrial thickn ess determined by transvaginal sonography (TVS) and hysteroscopic find ings in women with postmenopausal bleeding with histologic findings ob tained by dilatation and curettage (D&C). Methods: Eighty-one patients who had not received hormonal replacement therapy were scanned by tra nsvaginal probe, and double-layer endometrial thickness was measured 1 day before hysteroscopy and D&C. Results: The histologic diagnosis wa s atrophy in 12 cases, irregular proliferative changes in 21, endometr ial polyps in 16, hyperplasia in 16 and endometrial carcinoma in 16. T VS detected 46 of 48 pathologic conditions, including all cases of end ometrial carcinoma if the endometrial thickness (both layers) was grea ter than or equal to 5 mm (sensitivity 95.8%, specificity 45.5%). Hyst eroscopy also detected the endometrial pathology in 46 of 48 cases but with a higher specificity (sensitivity 95.3%, specificity 93.9%). Con clusion: TVS and hysteroscopy are complementary diagnostic methods and could be accurately used to discriminate between normal and pathologi c conditions in patients with postmenopausal bleeding.