Métodos de estudio de pacientes con sangrado uterino posmenopáusico: recomendaciones prácticas / Study methods of patients with postmenopausal uterine bleeding: practical recommendations

Resumen El sangrado uterino posmenopáusico se define como aquel sangrado que ocurre después del cese definitivo de la menstruación en la etapa reproductiva de la mujer como consecuencia de la claudicación biológica de los ovarios, o como un sangrado no esperado en mujeres con terapia de reposición hormonal sistémica de la menopausia. Representa el 5% de las consultas ginecológicas y, si bien su origen suele ser por causas benignas, puede requerir una evaluación minuciosa para descartar patologías malignas del endometrio. El objetivo de este trabajo es establecer un flujograma diagnóstico basado en la evidencia para la evaluación de las pacientes con sangrado uterino posmenopáusico.

Abstract Postmenopausal uterine bleeding is defined as the bleeding that occurs after the last menstruation due to loss of ovarian function, or a non-scheduled bleeding in patients with hormonal therapy. It represents 5% of the gynecologic visits, and even though its origin is often benign, it requires a thorough evaluation to discard malignant diseases. The objective of these review is to propose a diagnostic algorithm based on the available evidence for the evaluation of patients with postmenopausal uterine bleeding.

Clinical value of hysteroscopy in diagnosis of postmenopausal uterine bleeding / 中国基层医药

Objective To investigate the value of hysteroscopy in the diagnosis of postmenopausal uterine bleeding.Methods 106 cases of outpatient of postmenopausal bleeding were analyzed.Hysteroscopic diagnosis and the biopsy result were compared in all patients.Results Histological diagnosis was 73 cases of uterine cavity abnormality,33 cases of normal were diagnosed in hysteroscopy.78 cases of pathological abnormalities,and 28 cases of normal were diagnosed.Comparing to histology, sensitivity was 95.89% ,specificity 84.85% , positive predictive value 93.33% , negative predictive value of 90.32%.Conclusion Hysteroscopy combined pathology was the best method to diagnose postmenopausal uterus bleeding.