Diagnostic strategies for postmenopausal bleeding

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Date

2010

Authors

Breijer, M.
Timmermans, A.
van Doorn, H.
Mol, B.
Opmeer, B.

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Mclellan, R.

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Journal article

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Obstetrics and Gynecology International, 2010; 2010(1):1-5

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M. C. Breijer, A. Timmermans, H. C. van Doorn, B. W. J. Mol, and B. C. Opmeer

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Abstract

Postmenopausal bleeding (PMB) is a common clinical problem. Patients with PMB have 10%–15% chance of having endometrial carcinoma and therefore the diagnostic workup is aimed at excluding malignancy. Patient characteristics can alter the probability of having endometrial carcinoma in patients with PMB; in certain groups of patients the incidence has been reported to be as high as 29%. Transvaginal sonography (TVS) is used as a first step in the diagnostic workup, but different authors have come to different conclusions assessing the accuracy of TVS for excluding endometrial carcinoma. Diagnostic procedures obtaining material for histological assessment (e.g., dilatation and curettage, hysteroscopy, and endometrial biopsy) can be more accurate but are also more invasive. The best diagnostic strategy for diagnosing endometrial carcinoma in patients with PMB still remains controversial. Future research should be focussed on achieving a higher accuracy of different diagnostic strategies.

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© 2010 M. C. Breijer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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