Timmermans, A.van Doorn, L.Opmeer, B.Kroeks, M.Jitze Duk, M.Bouwmeester, A.Kruitwagen, R.Dijkhuizen, F.Mol, B.2015-09-102015-09-102008Obstetrics and Gynecology, 2008; 111(1):137-1430029-78441873-233Xhttp://hdl.handle.net/2440/94302OBJECTIVE: To estimate the incidence of recurrent postmenopausal bleeding among women who were diagnosed with an endometrial thickness greater than 4 mm. METHODS: We designed a prospective cohort study and included consecutive women not using hormone replacement therapy, presenting with a first episode of postmenopausal bleeding. We evaluated patients who had an endometrial thickness greater than 4 mm at transvaginal ultrasonography and benign endometrial sampling; presence of carcinoma was ruled out by office endometrial sampling, hysteroscopy, and/or dilation and curettage. Time until recurrent bleeding was measured, and diagnosis at recurrent bleeding was recorded. RESULTS: Among 318 patients who had an endometrial thickness greater than 4 mm, 222 patients had benign histology results and were available for follow-up. During follow-up, 47 (21%, 95% confidence interval 16–27%) patients had recurrent bleeding, with a median time to recurrent bleeding of 49 weeks (interquartile range 18 to 86 weeks). There was no difference with respect to recurrence rate between patients with polyp removal, patients with a normal hysteroscopy, and patients with office endometrial sampling alone at the initial workup. Two patients were diagnosed with atypical endometrial hyperplasia upon recurrent bleeding. CONCLUSION: The recurrence rate of postmenopausal bleeding in women with endometrial thickness greater than 4 mm is 20%. This recurrence rate is not related to incorporation of hysteroscopy or polyp removal at the initial workup.en© 2007 by The American College of Obstetricians and Gynecologists.Dutch Study in Postmenopausal Bleeding (DUPOMEB)EndometriumHumansMetrorrhagiaRecurrenceUltrasonographyHysteroscopyFollow-Up StudiesPostmenopauseAgedMiddle AgedFemaleJournal article002013678110.1097/01.AOG.0000296654.43944.e60002521999000182-s2.0-3754900513315374Mol, B. [0000-0001-6887-0262] [0000-0001-8337-550X]