Vaginal sonography of the endometrium in postmenopausal women.

The purpose of this study was to compare transvaginal ultrasound scanning and histology of the endometrium obtained by curettage. One hundred twenty women with postmenopausal bleeding were examined by vaginal sonography, before undergoing curettage. Endometrial thickness, as measured by vaginal sonography, was used as an indicator of endometrial abnormality. The mean endometrial thickness in those women with endometrial cancer was 16.6 +/- 5.4 mm as compared with 3.2 +/- 1.1 mm in those women with atrophic endometrium, and 9.5 +/- 2.3 in those with hyperplasia. If a cutoff limit of 5 mm had been used in this study, 82% of the curettage procedures could have been avoided, without missing a single case of serious endometrial pathology. We conclude that vaginal sonography is a reliable examination in the detection of endometrial abnormality in women with postmenopausal bleeding.