Follow-up of women after a first episode of postmenopausal bleeding and endometrial thickness greater than 4 millimeters
| Autor: | Anne Timmermans, R. F.M.P. Kruitwagen, M Jitze Duk, Lena C. van Doorn, Annette M. Bouwmeester, Ben W.J. Mol, Brent C. Opmeer, F. Paul H. L. J. Dijkhuizen, Maurice V. A. M. Kroeks |
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| Přispěvatelé: | Obstetrics and Gynaecology, Amsterdam Public Health, Epidemiology and Data Science |
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Metrorrhagia medicine.medical_treatment Hysteroscopy Dilation and curettage Endometrium Interquartile range Recurrence medicine Humans Prospective cohort study Atypical Endometrial Hyperplasia Aged Ultrasonography First episode medicine.diagnostic_test business.industry Obstetrics and Gynecology Immunotherapy gene therapy and transplantation [UMCN 1.4] Hormone replacement therapy (menopause) Middle Aged Surgery Postmenopause Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Obstetrics and gynecology, 111(1), 137-143. Lippincott Williams and Wilkins Obstetrics and Gynecology, 111, 137-43 Obstetrics and Gynecology, 111, 1, pp. 137-43 |
| ISSN: | 0029-7844 |
| Popis: | Contains fulltext : 70241.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To estimate the incidence of recurrent postmenopausal bleeding among women who were diagnosed with an endometrial thickness greater than 4 mm. METHODS: We designed a prospective cohort study and included consecutive women not using hormone replacement therapy, presenting with a first episode of postmenopausal bleeding. We evaluated patients who had an endometrial thickness greater than 4 mm at transvaginal ultrasonography and benign endometrial sampling; presence of carcinoma was ruled out by office endometrial sampling, hysteroscopy, and/or dilation and curettage. Time until recurrent bleeding was measured, and diagnosis at recurrent bleeding was recorded. RESULTS: Among 318 patients who had an endometrial thickness greater than 4 mm, 222 patients had benign histology results and were available for follow-up. During follow-up, 47 (21%, 95% confidence interval 16-27%) patients had recurrent bleeding, with a median time to recurrent bleeding of 49 weeks (interquartile range 18 to 86 weeks). There was no difference with respect to recurrence rate between patients with polyp removal, patients with a normal hysteroscopy, and patients with office endometrial sampling alone at the initial workup. Two patients were diagnosed with atypical endometrial hyperplasia upon recurrent bleeding. CONCLUSION: The recurrence rate of postmenopausal bleeding in women with endometrial thickness greater than 4 mm is 20%. This recurrence rate is not related to incorporation of hysteroscopy or polyp removal at the initial workup. LEVEL OF EVIDENCE: II. |
| Databáze: | OpenAIRE |
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