Endovaginal ultrasound scanning to identify bladder tumors as the source of vaginal bleeding in postmenopausal women.

The increasing frequency of bladder tumors with increasing age is well documented, but the incidence of bladder tumors in a subgroup at potential risk, i.e. women with postmenopausal bleeding, is, however, not known. In a prospective study of 400 women with postmenopausal bleeding, endovaginal scanning (EVS) was performed the day before planned dilatation and curettage (D & C). Five bladder tumors were identified. For comparison, the medical records of 4500 women admitted for D & C due to postmenopausal bleeding, during a 15-year period, were reviewed. These women were not examined by ultrasound preoperatively. Eight bladder tumors were found in these women. The number of bladder tumors found in women with postmenopausal bleeding was high, especially in the group of women that underwent endovaginal ultrasound, compared to the known incidence (25/100,000 women) in this age group. On the basis of the present data, it appears evident that EVS contributes to an early detection of bladder tumors. We emphasize the importance of scanning all women with postmenopausal bleeding with endovaginal ultrasound.