[Diagnostic value of combined vaginal ultrasound and hysteroscopy in peri- and postmenopausal bleeding].

OBJECTIVE

Is it possible to reduce the rate of curettages by using ultrasound and hysteroscopy?

METHODS

Transvaginal sonography, hysteroscopy, and dilation and curettage were performed in 103 patients with menometrorrhagia or postmenopausal bleeding. The patients were divided into three groups, depending on the ultrasound findings.

RESULTS

All 9 cases with cancer of the endometrium were found in group 3. 1 of the 9 carcinomas was not detected by hysteroscopy.

CONCLUSIONS

We believe that dilation and curettage is necessary in symptomatic women with an endometrial thickness < 4 as well as > 4 mm. Prospective studies have to clear the question of whether endometrial carcinomas can be detected by hysteroscopy in cases with an endometrium < 4 mm thick.