[Hysteroscopy findings in patients with postmenopausal genital bleeding]

Abstract

Objective: To describe morphological and histological findings in postmenopausal patients with abnormal uterine bleeding.

Patients and methods: An open, descriptive, observational, retrospective and cross sectional study was done at Clinica de Histeroscopia at Hospital Dr. Manuel Gea Gonzalez, in Mexico City. There were included 372 patients with postmenopausal abnormal uterine bleeding diagnosis without hormone replacement therapy. Hysteroscopy study was made with a 5 mm surgical hysteroscope using warm saline solution (280C) as a medium of distension, and a trans-hysteroscopy endometrial biopsy was taken for histopathological correlation. Statistic analysis was obtained using SPSS program version 10 for windows with a kappa test. In order to analyze more than two samples, we used the chi-square test.

Results: Endometrial atrophy was the most frequent hysteroscopic diagnosis (202 patients, 54.3%), followed by polyps (93 patients, 25%), cancer (14 patients, 4%) and hyperplasia (11 patients, 2.95%). Correlated results between hysteroscopic findings and hystopathological biopsy diagnosis obtained were: atrophy (157 cases, 63.3%), polyps (76 cases, 77.55%), endometrial cancer (14 cases, 93.05%), endometrial hyperplasia (10 cases, 90.63%) and miomatosis (three cases, 16.20%).

Conclusion: It can be stated that there is a high level of concordance between findings of hysteroscopic studies and the directed endometrial biopsy. So, we recommend initially the use of hysteroscopy for diagnosis and treatment of endometrial cavity malignant and benign pathology.