Comparison of the histopathological results of the endometrial thickness detected by transvaginal ultrasound of symptomatic and asymptomatic postmenopausal women

Objective: The purpose of the study was to assess the reliability of transvaginal ultrasound (TVUSG) in endometrial pathologies by comparing the ultrasonographic and histopathologic findings in symptomatic and asymptomatic postmenopausal women. Materials and Methods: In this retrospective study the data of 129 postmenopausal women that underwent dilatation and curettage was reviewed by dividing them two groups as symptomatic and asymptomatic. Symptomatic group was divided into subgroups according to the value of endometrial thickness obtained by TVUSG. Results: Among all subjects the cancer rate was found statistically 3.043 times higher in patients with the endometrial thickness of 15 mm and greater and atrophic endometrium rate was 75% in patients with the endometrial thickness of less than five mm. Endometrial thickness was found significantly higher in cancer patients than the others (p < 0.05). Among the patients with endometrial thickness of 15 mm and greater, the cancer rate was found higher in symptomatic group than in the asymptomatic group. The cancer rate was found statistically higher in patients with bleeding compared to asymptomatic ones with the endometrial thickness between 5-14.99 mm (p < 0.05). Cancer was not detected in any of the symptomatic patients with the endometrial thickness of less than five mm. Conclusion: Postmenopausal patients with the symptom of bleeding should undergo detailed gynecological and ultrasonographic examination. The authors believe that this study may be a strong support to the success of TVUSG as a screening method in both symptomatic and asymptomatic postmenopausal women. Furthermore if the patient is symptomatic with a thick endometrium, to exclude the malignancy, endometrial biopsy must be performed.

Postmenopausal bleeding; Transvaginal ultrasonography; Endometrial thickness; Endometrium cancer; Menopause.

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