Transvaginal Sonography versus Histopathology in Postmenopausal Bleeding: A Prospective Study.

ABSTRACT

We compared Transvaginal Sonography (TVS) with histopathological results of the dilatation and curettage biopsies in 50 women with postmenopausal bleeding attending Gynaecology out-patient department of SMGS hospital, Jammu. These women underwent TVS followed by histopathological examination of endometrium. Endometrial lesions detected by histopathology in these women were hormonal effects (proliferative and secretary endometrium) in 5 (10%), endometrial polyps in 4 (8%), endometritis in 2 (4%), endometrial hyperplasia in 9 (18%) and endometrial carcinoma in 5 (10%). A total of 21 (42%) showed atrophic endometrium and in 4 (8%) women, sample was insufficient. On TVS, 24 (48%) women had endometrial thickness (ET) < 5 mm and 26 (52%) women had ET > 5 mm. At a cut-off limit of > 5 mm for endometrial thickness indicating pathologic endometrium, the sensitivity and specificity of TVS was 100% and 80% respectively and a predictive value as a positive test, as a negative test and accuracy was 76.9%, 100% and 89% respectively. This study shows that TVS allows detection of endometrial pathology in vast majority of women and it is relatively easy, cheap, non-invasive and does not require anesthesia. It can be used as the first diagnostic step in the investigations of women with postmenopausal bleeding.