Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium: Hysteroscopic and histological results

Rosalia Maria Rita Loiacono, Giuseppe Trojano, Nicola Del Gaudio, Anila Kardhashi, Maria Assunta Deliso, Gaetano Falco, Rita Sforza, Anna Franca Laera, Ida Galise, Vito Trojano

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: This study compares hysteroscopic and histopathological results in postmenopausal women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium. Materials and Methods: This is a retrospective study of 570 cases hysteroscopically examined between January 2008 and July 2012. The patients were followed up at the Istituto Tumori 'Giovanni Paolo II', Bari, Italy. Results: A total of 320 of the 570 cases were selected. The inclusion criteria were transvaginal ultrasound, hysteroscopy and endometrial biopsy. In the AUB group, if the hysteroscopy results were normal, a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100, 95, 71 and 100%, respectively, were achieved, while in the asymptomatic group these values were 100, 97, 90 and 100%, respectively. For both the group with polyps and that with myomas, the sensitivity, specificity, PPV and NPV were 100%. For endometrial hyperplasia, hysteroscopy showed a sensitivity, specificity, PPV and NPV of 81, 96, 87 and 93%, respectively, in the AUB group, while in the asymptomatic group, the sensitivity was 60%, the specificity and PPV were 100%, and the NPV was 98%. The sensitivity of hysteroscopy for endometrial cancer was 63%, the specificity 97%, the PPV 77%, and the NPV 95%. Conclusions: In postmenopausal women with a thickened endometrium with or without AUB, hysteroscopy allows for an accurate diagnosis in benign endometrial pathology. Hysteroscopy also allows directed biopsies of suspicious lesions, which is useful in malignant endometrial pathology.

Original languageEnglish
Pages (from-to)210-216
Number of pages7
JournalGynecologic and Obstetric Investigation
Volume79
Issue number3
DOIs
Publication statusPublished - Apr 6 2015

Fingerprint

Hysteroscopy
Endometrium
Uterine Hemorrhage
Pathology
Hemorrhage
Sensitivity and Specificity
Endometrial Hyperplasia
Biopsy
Myoma
Endometrial Neoplasms
Polyps
Italy
Retrospective Studies

Keywords

  • Endometrial pathology
  • Endometrium
  • Hysteroscopy
  • Postmenopausal bleeding

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium : Hysteroscopic and histological results. / Loiacono, Rosalia Maria Rita; Trojano, Giuseppe; Del Gaudio, Nicola; Kardhashi, Anila; Deliso, Maria Assunta; Falco, Gaetano; Sforza, Rita; Laera, Anna Franca; Galise, Ida; Trojano, Vito.

In: Gynecologic and Obstetric Investigation, Vol. 79, No. 3, 06.04.2015, p. 210-216.

Research output: Contribution to journalArticle

Loiacono, Rosalia Maria Rita ; Trojano, Giuseppe ; Del Gaudio, Nicola ; Kardhashi, Anila ; Deliso, Maria Assunta ; Falco, Gaetano ; Sforza, Rita ; Laera, Anna Franca ; Galise, Ida ; Trojano, Vito. / Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium : Hysteroscopic and histological results. In: Gynecologic and Obstetric Investigation. 2015 ; Vol. 79, No. 3. pp. 210-216.
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T1 - Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium

T2 - Hysteroscopic and histological results

AU - Loiacono, Rosalia Maria Rita

AU - Trojano, Giuseppe

AU - Del Gaudio, Nicola

AU - Kardhashi, Anila

AU - Deliso, Maria Assunta

AU - Falco, Gaetano

AU - Sforza, Rita

AU - Laera, Anna Franca

AU - Galise, Ida

AU - Trojano, Vito

PY - 2015/4/6

Y1 - 2015/4/6

N2 - Objective: This study compares hysteroscopic and histopathological results in postmenopausal women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium. Materials and Methods: This is a retrospective study of 570 cases hysteroscopically examined between January 2008 and July 2012. The patients were followed up at the Istituto Tumori 'Giovanni Paolo II', Bari, Italy. Results: A total of 320 of the 570 cases were selected. The inclusion criteria were transvaginal ultrasound, hysteroscopy and endometrial biopsy. In the AUB group, if the hysteroscopy results were normal, a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100, 95, 71 and 100%, respectively, were achieved, while in the asymptomatic group these values were 100, 97, 90 and 100%, respectively. For both the group with polyps and that with myomas, the sensitivity, specificity, PPV and NPV were 100%. For endometrial hyperplasia, hysteroscopy showed a sensitivity, specificity, PPV and NPV of 81, 96, 87 and 93%, respectively, in the AUB group, while in the asymptomatic group, the sensitivity was 60%, the specificity and PPV were 100%, and the NPV was 98%. The sensitivity of hysteroscopy for endometrial cancer was 63%, the specificity 97%, the PPV 77%, and the NPV 95%. Conclusions: In postmenopausal women with a thickened endometrium with or without AUB, hysteroscopy allows for an accurate diagnosis in benign endometrial pathology. Hysteroscopy also allows directed biopsies of suspicious lesions, which is useful in malignant endometrial pathology.

AB - Objective: This study compares hysteroscopic and histopathological results in postmenopausal women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium. Materials and Methods: This is a retrospective study of 570 cases hysteroscopically examined between January 2008 and July 2012. The patients were followed up at the Istituto Tumori 'Giovanni Paolo II', Bari, Italy. Results: A total of 320 of the 570 cases were selected. The inclusion criteria were transvaginal ultrasound, hysteroscopy and endometrial biopsy. In the AUB group, if the hysteroscopy results were normal, a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100, 95, 71 and 100%, respectively, were achieved, while in the asymptomatic group these values were 100, 97, 90 and 100%, respectively. For both the group with polyps and that with myomas, the sensitivity, specificity, PPV and NPV were 100%. For endometrial hyperplasia, hysteroscopy showed a sensitivity, specificity, PPV and NPV of 81, 96, 87 and 93%, respectively, in the AUB group, while in the asymptomatic group, the sensitivity was 60%, the specificity and PPV were 100%, and the NPV was 98%. The sensitivity of hysteroscopy for endometrial cancer was 63%, the specificity 97%, the PPV 77%, and the NPV 95%. Conclusions: In postmenopausal women with a thickened endometrium with or without AUB, hysteroscopy allows for an accurate diagnosis in benign endometrial pathology. Hysteroscopy also allows directed biopsies of suspicious lesions, which is useful in malignant endometrial pathology.

KW - Endometrial pathology

KW - Endometrium

KW - Hysteroscopy

KW - Postmenopausal bleeding

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