Abstract
Introduction.-Post-menopausal bleeding (PMB) are frequently found in gynaecological consultations and requires the search of an organic cause.
Aim.-To establish a correlation between findings of endovaginal ultrasound and histology in women consulting for PMB.
Patients and methods.-The authors conducted a retrospective analytical study in 82 women with PMB consulting in gynaecology and obstetrics department of CHU Hedi Chaker of Sfax, during the period of January 1st, 2004 to February 28th, 2005. A correlation between endovaginal sonographic and histological data was established, according to different aetiologies.
Results.-Transvaginal ultrasound showed an endometrial depth greater than 5mm in 49 patients (59.7%), an intracavitary image in 29 patients (24.8%), an endometrial malignancy suspicious lesion in 10 patients (8.5%), an uterine myoma in 35 patients (29%) and ovarian pathologies in nine cases (6.9%). For a threshold value of 5mm, the correlation between the thicknesses of the endometrium with the histological results is not significant (p > 0.05) for all type of pathology. It is the same, except in the case of endometrial cancer, for a threshold value equal to 8mm (p < 0.05). Endovaginal sonography shows a sensitivity of 100% in the detection of an endometrial cancer. It presents low sensitivity estimated at 26.8% in detecting polyps, average sensitivity around 51% in the diagnosis of endometrial atrophy and good sensitivity and specificity around 75% in uterine myoma detection.
Conclusion.-Endovaginal sonography is recommended as a first intention examination for the diagnosis of post-menopausal metrorrhagia. It shows different sensitivities varying with aetiology. (C) 2009 Elsevier Masson SAS. All rights reserved.