TRANSVAGINAL ULTRASOUND, UTERINE BIOPSY AND HYSTEROSCOPY FOR POSTMENOPAUSAL BLEEDING

Objectives: To determine the importance of endometrial biopsy and tran svaginal ultrasound in patients with postmenopausal bleeding. Methods: Eighty patients with postmenopausal bleeding were submitted to transv aginal ultrasound followed by endometrial biopsy. Hysteroscopy and dil atation and curettage were carried out to confirm normality of the ute rine cavity. Results: The endometrial echo could be visualized in all patients with postmenopausal bleeding. The biopsy failed to detect one case (1.38%) of adenocarcinoma and 14 cases (17.5%) of endometrial po lyps. The sensitivity in detecting endometrial malignancy was 94.44% f or endometrial biopsy and 100% for transvaginal ultrasound, when the e ndometrial thickness was more than 8 mm. Conclusions: When the thickne ss of the endometrial echo is less than 3 mm there is no need for anat omopathologic investigation. When this limit was adopted, all cases we re associated with endometrial atrophy, and when the limit was 4 mm or more, active endometria were detected, requiring further histopatholo gic investigation by hysteroscopy and directed biopsies. Above 8 mm, m alignancy may be found.