[Diagnosis and treatment of postmenopausal uterine bleeding by hysteroscopy].

OBJECTIVES

To evaluate the value of hysteroscopy in diagnosis and treatment of patients with postmenopausal uterine bleeding.

METHODS

One hundred and thirty-five patients with postmenopausal bleeding hospitalized in our department from July 1990 to July 1994 were examined by hysteroscopy. The results of 124 cases were compared with pathological findings obtained during uterine curettage. Thirty-nine patients were operated simultaneously under hysteroscopy.

RESULTS

Under hysteroscopy, atrophic endometrium, endometrial polyps, cervical polyps, endometrial carcinoma, endometrial hyperplasia, submucous myoma were diagnosed in 62 cases (45.9%), 25 cases (18.5%), 13 cases (9.6%), 13 cases (9.6%), 11 cases (8.2%) and 5 cases (3.7%) respectively. The remaining 6 (4.5%) had IUD insertion. These findings were confirmed pathologically in 115 out of 124 cases (92.7%). There were 9 cases misdiagnosed by hysteroscopy. 6 cases had false negative results during previous curettage. Twenty-two cases of endometrial polyps, 13 cases of cervical polyps and 4 cases of pediculated submucous myoma were removed hysteroscopically without any complication.

CONCLUSIONS

Hysteroscopy is an effective method for identifying the causes of postmenopausal uterine bleeding, which is superior to curettage of uterus. For some selected patients hysteroscopic operations can be performed at the same time.