Postmenopausal bleeding: A diagnostic approach for both private and public sectors
dc.contributor.author | Spicer J.M. | |
dc.contributor.author | Siebert I. | |
dc.contributor.author | Kruger T.F. | |
dc.date.accessioned | 2011-05-15T16:16:29Z | |
dc.date.available | 2011-05-15T16:16:29Z | |
dc.date.issued | 2006 | |
dc.description.abstract | Objective: To assess the optimal diagnostic approach to women with postmenopausal bleeding by comparing transvaginal ultrasound and endometrial sampling with office hysteroscopy. Methods: A prospective collective study was performed on 102 consecutive patients with postmenopausal bleeding who were evaluated by ultrasound measurement of the endometrial thickness (EL), endometrial sampling by Accurette® and outpatient hysteroscopy and directed biopsy. Results: Accurette was inadequate for histological diagnosis in 65 of 136 samples and many repeat investigations were required. In all 16 cases of endometrial polyps, ultrasound measurement of the EL was ≥4 mm and hysteroscopy confirmed the findings. Accurette detected only 5 polyps. All 7 cases of endometrial hyperplasia were detected using an EL of ≥4 mm and hysteroscopy confirmed the findings. Accurette failed to detect 5 out of 7 cases of endometrial hyperplasia. Five cases of endometrial cancer were diagnosed: all had an EL ≥4 mm but were inadequately sampled for diagnostic purposes in 3 cases. A definitive diagnosis was made on hysteroscopy in 4 cases (1 patient did not have a hysteroscopy). Conclusion: Accurette is not a good sampling device for the diagnosis of postmenopausal bleeding. An ultrasound measurement of the EL ≥4 mm in patients with postmenopausal bleeding warrants further investigation. Outpatient office hysteroscopy is an accurate and sensitive modality to employ as a first line investigation for definitive diagnosis. Copyright © 2006 S. Karger AG. | |
dc.description.version | Article | |
dc.identifier.citation | Gynecologic and Obstetric Investigation | |
dc.identifier.citation | 61 | |
dc.identifier.citation | 3 | |
dc.identifier.issn | 03787346 | |
dc.identifier.other | 10.1159/000091413 | |
dc.identifier.uri | http://hdl.handle.net/10019.1/13803 | |
dc.subject | adult | |
dc.subject | aged | |
dc.subject | article | |
dc.subject | bleeding | |
dc.subject | controlled study | |
dc.subject | diagnostic accuracy | |
dc.subject | diagnostic procedure | |
dc.subject | echography | |
dc.subject | endometrium | |
dc.subject | endometrium cancer | |
dc.subject | endometrium hyperplasia | |
dc.subject | endometrium polyp | |
dc.subject | female | |
dc.subject | human | |
dc.subject | human tissue | |
dc.subject | hysteroscopy | |
dc.subject | intermethod comparison | |
dc.subject | major clinical study | |
dc.subject | menopausal syndrome | |
dc.subject | organization and management | |
dc.subject | outpatient | |
dc.subject | postmenopause | |
dc.subject | priority journal | |
dc.subject | sensitivity and specificity | |
dc.subject | transvaginal echography | |
dc.subject | uterus biopsy | |
dc.subject | Adenocarcinoma | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Biopsy | |
dc.subject | Endometrial Hyperplasia | |
dc.subject | Endometrial Neoplasms | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Hysteroscopy | |
dc.subject | Middle Aged | |
dc.subject | Mixed Tumor, Mullerian | |
dc.subject | Polyps | |
dc.subject | Postmenopause | |
dc.subject | Private Sector | |
dc.subject | Prospective Studies | |
dc.subject | Public Sector | |
dc.subject | Sensitivity and Specificity | |
dc.subject | South Africa | |
dc.subject | Ultrasonography, Interventional | |
dc.subject | Uterine Diseases | |
dc.subject | Uterine Hemorrhage | |
dc.title | Postmenopausal bleeding: A diagnostic approach for both private and public sectors | |
dc.type | Article |