OBJECTIVE: To evaluate the usefulness of transvaginal sonographic measurement of endometrial thickness with Progestin-Induced Withdrawal as a screening method for endometrial pathology in postmenopausal women.

DESIGN: This study is an observational case control research design.

METHODOLOGY: One hundred forty three registered postmenopausal women at VMMC Out Patient Department were examined by TVS: 60 asymptomatic women (Group A) and 83 with uterine bleeding (Group B). Endometrial thickness of 5 mm was considered pathological. All women with abnormal endometrium from group A underwent PCT. All women from group A were positive for PCT and all women from group B underwent D&C. Histologic findings of hyperplasia w/ or w/o atypia, polyp and cancer were considered pathologic. Validity testing method was then used by measuring the sensitivity, specificity, positive predictive and negative predictive values of the data collected.

RESULTS: Eighteen women with a (+) PCT who underwent D&C revealed 6 benign histologic finding: Endometrial Polyp (2), Hyperplasia without atypia (4), 3 were premalignant and 1 case of Endometrial Cancer. All women with negative PCT had non-pathologic histologic findings. Validity testing showed that a Positive PCT in a asymptomatic patients with a sonographic endometrial thickness of 5mm, has a sensitivity of 100 percent, specificity of 46.66 percent,(+) predictive value of 55.55 percent and negative predictive value of 100 percent. Sixty two patients from Group B had abnormal sonographic and histologic findings: 13 benign (hyperplasia or polyp), 10 premalignant (hyperplasia w/ atypia) and 18 malignant (cancer). There was no cancer in cases w/ endometrial thickness 5 mm. The sensitivity, specificity, positive and negative predictive value of TVS for detecting endometrial pathology were 93.94 percent, 94.74 percent, 98.41 percent and 81.82 percent respectively if the cut-off limit of 5 mm was used.

CONCLUSION: TVS combined with PCT is a useful and reliable method for identifying endometrial pathology in postmenopausal women. (Author)

Human ; Female ; Progestins ; Hyperplasia ; Postmenopause ; Endometrial Hyperplasia ; Uterine Hemorrhage ; Endometrial Neoplasms ; Endometrium ; Polyps