The contribution of the transvaginal hysterosonography in the evaluation of postmenopausal bleeding

Skartados N, Kalmandis K, Papadoniou N, Daskalakis G, Mesogitis S, Antsaklis A

1st Department of Obstetrics and Gynecology, University of Athens, Alexandra hospital, Athens, Greece

Correspondence: Skartados N, 134 Kaukasou St, GR-11364, Athens, Greece. E-mail:


The aim of our study was to identify the role of transvaginal hysterosonography (HS) in postmenopausal women with unexplained bleeding. Sixty six women with unexplained metrorrhage, aged between 49 and 64 years were included in the study. After a transvaginal ultrasound, a saline hysterosonography was performed in all cases. Following this, all women were referred for dilatation and curettage, and histology results were compared to the sonographic findings. The HS procedure was well tolerated with no significant complication. In 22 cases an endometrial polyp was found, in 8 cases there was endometrial hyperplasia, in 12 cases endometrial cancer and in 20 cases the endometrium was normal. There was 1 false positive result (endometrial hyperplasia). Hysterosonography may become the procedure of choice for office evaluation of the endometrial cavity. It is well tolerated by patients. HS is superior to TVS in the evaluation of endometrial pathology in postmenopausal women with unexplained bleeding.

Keywords: sonohysterography, transvaginal ultrasound, postmenopausal bleeding, intrauterine abnormalities

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