Background:

Currently, the measurement of endometrial thickness by sonography or endometrial curettage is the single criterion used for the assessment of the endometrium in postmenopausal women.

Objective:

The aim of this study was to determine the accuracy and usefulness of transvaginal sonography as a diagnostic method for determining pathological versus nonpathological changes in the endometrium, by comparing sonographic results with histopathological results following endometrial curettage.

Methods and materials:

This was a prospective study in 150 women, aged 45 to 70 years, who were hospitalized for different reasons at the Obstetric-Gynecology Clinic in Prishtina, Kosovo during 2007. Transvaginal sonography was performed in all 150 patients. Endometrial curettage was performed in 82 patients, and the tissues were sent for histopathological examination.

Results:

More than one-third of the patients had an endometrial thickness between 3 and 10 mm. Within this group, histopathological examinations showed no evidence of any pathological changes. Meanwhile, in patients with an endometrial thickness >10 mm, the histopathological findings revealed hyperplasia, polyposis, carcinomas, and other pathologies. Changes in the form of atypical hyperplasia were present in 23% of the patients, and endometrial carcinoma was observed in 5% of patients.

Conclusion:

The use of transvaginal sonography in combination with histopathology from endometrial curettage can improve the accuracy of pathological findings as well as the selectivity of the assessment of the endometrium in postmenopausal women.

Keywords: postmenopausal endometrial changes, endometrial thickness, transvaginal sonography, histopathology analysis