Is hysteroscopy mandatory in all women with post-menopausal bleeding and thickened endometrium on scan?

摘要

Historically, if a woman presented with post-menopausal bleeding (PMB) she would undergo blind dilatation and curettage (D&C) under general anaesthesia to determine whether or not she had an underlying endometrial cancer. Currently, with the advent of high-resolution transvaginal ultrasound, it is possible to obtain highly magnified images of the endometrium. This advance, when combined with the use of other diagnostic tools (saline-infusion sonohysterography (SIS), office endometrial biopsy and hysteroscopy), can optimise the diagnosis of uterine pathology and make the current management of women with PMB much more individualised.