Office hysteroscopy in the management of women with postmenopausal bleeding

Abstract

Postmenopausal bleeding (PMB) is a relevant aspect for health-care providers in clinical practice: the first objective is to rule out potential gynecological cancer. The purpose of this narrative review is to evaluate the role of office hysteroscopy in the management of PMB. Office hysteroscopy is a minimally invasive procedure allowing direct visualization of uterine pathology without the need for general anesthesia and the use of an operating room, generating cost savings and greater compliance among patients. Here, we focus on major intrauterine diseases (polyps, submucosal myomas, endometrial hyperplasia, and cancer) as causes of PMB. Office hysteroscopy appears to be safe and feasible, and could allow accurate diagnosis of intrauterine pathologies, especially that with a focal growth pattern, otherwise misdiagnosed with blinded procedures. However, studies focusing exclusively on postmenopausal women are still few, so further research, especially randomized controlled trials, is needed.

绝经后出血(PMB)是医务人员临床实践中的一个相关方面：首要目标是排除潜在的妇科肿瘤。本篇叙述性综述的目的在于评估门诊宫腔镜在PMB管理中的作用。门诊宫腔镜是一种微创技术, 无需全身麻醉和手术室即可直接观察子宫病变, 从而节省成本并提高患者的依从性。在这里, 我们聚焦于引起PMB的几个主要宫内疾病(息肉、黏膜下肌瘤、子宫内膜增生与子宫内膜癌)。门诊宫腔镜是安全可行的, 可以准确诊断宫内病变, 特别是有局灶性生长的宫内病变, 否则就会因盲法刮宫误诊。然而, 专门针对绝经后妇女的研究仍然很少, 需要进一步的研究, 特别是随机对照试验。

Keywords:

• Postmenopausal vaginal bleeding
• office hysteroscopy
• polyps
• myomas
• endometrial hyperplasia
• endometrial cancer
• target eye biopsy
• treatment

Potential conflict of interest

Dr Giampaolino, Dr Della Corte, Dr Di Filippo, Dr Mercorio, Dr Vitale, and Dr Bifulco have no conflicts of interest or financial conflicts to disclose

Source of funding

Nil.