Abstract
Objectives
The aim of the study was to assess the clinical significance of intra-uterine fluid
collection in postmenopausal women with cervical stenosis with and without vaginal
bleeding.
Methods
A group of 82 consecutive postmenopausal women with cervical stenosis and sonographically
confirmed intra-uterine fluid collection underwent D&C with or without hysteroscopy.
Diagnostic hysteroscopy was performed in all patients with an endometrial thickness
(ET) was greater than 8 mm, or with irregular endometrium at any degree of ET. The patients were divided and
evaluated prospectively into two groups according to the presence or absence of postmenopausal
bleeding (PMB). Twenty-six women were with PMB and 56 women were asymptomatic.
Results
The groups were similar as far as endometrial thickness and histopathological results
were concerned. Atrophic endometrium was found in 69 patients (84%), 23 in the PMB
group (89%) and 46 in the other group (82%), proliferative endometrium in 7 (9%) and
endometrial polyps were found in 35 patients (43%), 12 in the PMB group (46%) and
23 in the other group (41%). When ET was ≥8 mm, in 93% of the cases an endometrial polyp was found (25 out of 27). No case of
endometrial cancer was found. A premalignant condition was diagnosed in one patient
with an endometrial polyp in the PMB group.
All patients with endometrial thickness of less than 3 mm in ultrasound had atrophic endometrium. The incidence of intrauterine pathology
increased with the increasing thickness of endometrium as observed by ultrasound.
Conclusions
The presence of intra-uterine fluid collection in postmenopausal patients with cervical
stenosis seems to be a benign condition. Normal endometrium of less than 3 mm observed by ultrasound in postmenopausal women without vaginal bleeding does not
necessarily need further surgical investigation.
Keywords
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Article info
Publication history
Published online: July 13, 2006
Accepted:
April 4,
2006
Received in revised form:
March 29,
2006
Received:
October 16,
2005
Identification
Copyright
© 2006 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
