The role of office hysteroscopy in symptomatic or asymptomatic patients in the postmenopausal period

Abstract

Introduction/Background The role of office hysteroscopy in symptomatic or asymptomatic patients in the postmenopausal period Methodology This retrospective document study comprised 347 patients who had undergone office hysteroscopy and endometrial biopsy in our hospital since 2015. Age, BMI, presence of symptoms, endometrial thickness in sonographic evaluation, and histological diagnosis were analyzed. The study population was divided into five groups based on their histological diagnoses: benign/physiological endometrium (group A), endometrial polyp (group B), endometrial hyperplasia or intraepithelial neoplasia(EIN)(group C), endometrioid carcinoma (group D) and non-endometrioid carcinoma (group E) Results A total of 347 patients underwent office hysteroscopy and endometrial biopsy (77 asymptomatic, 270 postmenopausal bleeding). The median age of the patients was 54, and the mean BMI was 29.8 kg/m2. The distribution of patients was n=157(%45.2) Group A, n=155 (44.7) Group B, n=14 (%4) Group C, n=17 (%4.9) Group D, n=4 (%1.2) Group E patients. Endometrial thickness was increasing from Group A to Group E. The mean endometrial thickness is 9.2mm, 10.4mm, 13.8mm, 14.4mm, 16.2mm, respectively. Cancer was detected in 20 (7.3%) of 271 patients with postmenopausal bleeding. Cancer was detected in only one of the asymptomatic patients. Endometrial cancer was present in 5.6% of the patients with postmenopausal polyps. When the endometrial thickness threshold was 10 mm, 7/35 (20%) patients could not be diagnosed with cancer. When the endometrial thickness threshold was 20 mm, this figure 1 increased to 25/35 (71.4%). Conclusion Postmenopausal bleeding is a condition that needs attention due to the risk of endometrial cancer. In asymptomatic patients, if there is no obvious focal lesion, office hysteroscopy may not be performed.