Comparison of transvaginal ultrasound, hysteroscopy, and dilatation and curettage in the diagnosis of abnormal vaginal bleeding and intrauterine pathology in perimenopausal and postmenopausal women.

STUDY

OBJECTIVE

To compare transvaginal ultrasound, hysteroscopy, and dilation and curettage (D&C) in the evaluation of women with perimenopausal and postmenopausal bleeding.

DESIGN

Descriptive study (Canadian Task Force classification II-1).

SETTING

Seven outpatient clinics.

PATIENTS: One thousand two hundred eighty-six women.

INTERVENTION: Transvaginal ultrasound, hysteroscopy, and D&C.

MEASUREMENTS AND MAIN

RESULTS

Of our patient population, 29 (2.26%) had a histologic diagnosis of endometrial carcinoma; in 2 of them (7.14%) endometrial thickness was 5 mm or less. In 10 women (34.5%), endometrial carcinoma was missed by hysteroscopy (sensitivity 65.52%, specificity 99.92%). Complication rate of D&C was 1.4%.

CONCLUSION

In women with perimenopausal and postmenopausal bleeding neither transvaginal ultrasound nor hysteroscopy as a single diagnostic tool is suitable to rule out endometrial cancer.