Gynaecology Research Today is a free monthly online journal that collates and summarizes the latest research about Gynaecology, including details on pap smears, laparoscopy, ultrasound, hysteroscopy.

Hysteroscopy in the diagnosis of postmenopausal bleeding.

Guruwadayarhalli B, Jones SE, Srinivasan V

Bradford Royal Infirmary, Bradford, UK.

Postmenopausal bleeding (PMB) accounts for 5% of gynaecology referrals. Investigations should exclude malignancy and pre-malignancy, and diagnose the benign conditions that need treatment. The three modalities that are most commonly used are transvaginal ultrasound scan (TVS), endometrial biopsy (EB) and hysteroscopy. Most authors agree that the first-line investigation should be TVS, followed by endometrial assessment (EB or hysteroscopy) if the endometrial thickness is >4 mm. When scanning demonstrates the possibility of pathology, outpatient hysteroscopy and biopsy are the gold standard for investigating the endometrial cavity. Focal pathology can be removed during the hysteroscopy, thereby reducing hospital admissions and costs.

Published 5 September 2007 in Menopause Int, 13(3): 132-4.
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