COMPARATIVE-STUDY OF TRANSVAGINAL SONOGRAPHY AND HYSTEROSCOPY FOR THEDETECTION OF PATHOLOGICAL ENDOMETRIAL LESIONS IN WOMEN WITH POSTMENOPAUSAL BLEEDING

Dilatation and curettage is used as the ''gold standard'' for diagnosi ng pathologic endometrial lesions in women with postmenopausal bleedin g. In this group of women, about 10% have an endometrial cancer and an additional 20% have some other endometrial abnormality. However, some abnormalities, such as endometrial polyps and submucous fibroids, are difficult to diagnose by dilatation and curettage. In such cases, com bining transvaginal sonography with hysteroscopy may be of value. This study compared the use of transvaginal sonography and hysteroscopy fo r evaluation of the uterine cavity in women with postmenopausal bleedi ng. The study included 51 women, 39 of whom had an abnormally thick (> 4 mm) endometrium as measured by transvaginal sonography, and 35 of 3 9 had an abnormal appearance at hysteroscopy. The sensitivity and spec ificity for the measurement of endometrial thickness using transvagina l sonography to diagnose an endometrial abnormality were 100% and 75%, respectively. The corresponding figures for hysteroscopy were 97% and 88%. In all women with an endometrial thickness of 8 mm as measured b y transvaginal sonography, hysteroscopy is identified as an abnormalit y. The study indicates that transvaginal sonography reveals an endomet rial thickness of greater than or equal to 8 mm and the histopathologi c diagnosis after dilatation and curettage is atrophic endometrium, hy steroscopy will probably reveal an endometrial polyp or submucous myom a.