Transvaginal sonography and endometrial thickness in patients with postmenopausal uterine bleeding

The objective of the present study was to evaluate the usefulness of transvaginal ultrasonography in assessment of the endometrial thickness in patients with postmenopausal uterine bleeding in relation to the histopathological results of the endometrial biopsy. A total of 118 women with postmenopausal uterine bleeding were studied prospectively. Thirty postmenopausal women without vaginal bleeding and without gynaecological complaints served as a control group. In women with histopathological diagnosis of atrophic endometrium the mean endometrial thickness was 3.1 +/- 1.7 mm whereas the corresponding value for patients with endometrial carcinoma was 18.4 +/- 8.2 mm (P < 0.001). No endometrial carcinoma was diagnosed in endometrial thickness < or = 6 mm. The sensitivity was 100% and specificity 64% if a 6-mm cutoff limit was used. We consider that transvaginal ultrasonographic investigation for post-menopausal bleeding may provide useful information for selection of those patients who are under higher risk of endometrial abnormalities. When using vaginal sonography for measuring the endometrial thickness in women with postmenopausal bleeding, it is reasonable not to perform a dilatation and curettage if the endometrial thickness is < or = 6 mm.