Postmenopausal bleeding: A diagnostic approach for both private and public sectors

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dc.contributor.authorSpicer J.M.
dc.contributor.authorSiebert I.
dc.contributor.authorKruger T.F.
dc.date.accessioned2011-05-15T16:16:29Z
dc.date.available2011-05-15T16:16:29Z
dc.date.issued2006
dc.description.abstractObjective: 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.versionArticle
dc.identifier.citationGynecologic and Obstetric Investigation
dc.identifier.citation61
dc.identifier.citation3
dc.identifier.issn03787346
dc.identifier.other10.1159/000091413
dc.identifier.urihttp://hdl.handle.net/10019.1/13803
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectbleeding
dc.subjectcontrolled study
dc.subjectdiagnostic accuracy
dc.subjectdiagnostic procedure
dc.subjectechography
dc.subjectendometrium
dc.subjectendometrium cancer
dc.subjectendometrium hyperplasia
dc.subjectendometrium polyp
dc.subjectfemale
dc.subjecthuman
dc.subjecthuman tissue
dc.subjecthysteroscopy
dc.subjectintermethod comparison
dc.subjectmajor clinical study
dc.subjectmenopausal syndrome
dc.subjectorganization and management
dc.subjectoutpatient
dc.subjectpostmenopause
dc.subjectpriority journal
dc.subjectsensitivity and specificity
dc.subjecttransvaginal echography
dc.subjectuterus biopsy
dc.subjectAdenocarcinoma
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectBiopsy
dc.subjectEndometrial Hyperplasia
dc.subjectEndometrial Neoplasms
dc.subjectFemale
dc.subjectHumans
dc.subjectHysteroscopy
dc.subjectMiddle Aged
dc.subjectMixed Tumor, Mullerian
dc.subjectPolyps
dc.subjectPostmenopause
dc.subjectPrivate Sector
dc.subjectProspective Studies
dc.subjectPublic Sector
dc.subjectSensitivity and Specificity
dc.subjectSouth Africa
dc.subjectUltrasonography, Interventional
dc.subjectUterine Diseases
dc.subjectUterine Hemorrhage
dc.titlePostmenopausal bleeding: A diagnostic approach for both private and public sectors
dc.typeArticle
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