Format

Send to:

Choose Destination
See comment in PubMed Commons below
Acta Obstet Gynecol Scand. 2004 Jan;83(1):89-95.

Management of postmenopausal bleeding in Sweden: a need for increased use of hydrosonography and hysteroscopy.

Author information

  • 1Department of Obstetrics and Gynecology, Malmö University Hospital, SE-205 02 Malmö, Sweden. elisabeth.epstein@obst.mas.lu.se

Abstract

BACKGROUND:

The objective was to determine how postmenopausal bleeding (PMB) is managed in Sweden today, and to relate the findings to a new evidence-based algorithm for the management of PMB.

METHODS:

A questionnaire regarding the role of ultrasound and the use of different endometrial biopsy methods in the management of PMB was sent to all 61 gynecologic departments in Sweden.

RESULTS:

Fifty-nine of the 61 departments (97%) satisfactorily answered the questionnaire. Ultrasound was either always (n = 54, 92%) or most commonly (n = 5, 8%) used in the diagnostic work-up of PMB. In women with endometrial thickness < or =4 mm, 18 of the departments (31%) routinely sampled the endometrium; 12 (15%) followed the women with ultrasound; three (5%) did both sampling and follow-up with ultrasound; and the remaining 29 (49%) used expectant management (i.e. no biopsy or routine follow-up). In women with endometrium > or =5 mm, hydrosonography was performed routinely in two departments (3%), occasionally in 37 departments (63%), and never in 20 departments (34%). In women with endometrium > or =5 mm, endometrial biopsy was obtained routinely by Endorette/Pipelle in 39 departments (66%), while in 26 departments (44%) operative hysteroscopy was never performed.

CONCLUSION:

More than one-third of the gynecologic departments in Sweden never perform hydrosonography to rule out focal lesions or operative hysteroscopy for the removal of such lesions. Hydrosonography and hysteroscopy have a central role in the new guidelines for the management of PMB. Therefore, a need exists to broaden the use of hydrosonography and hysteroscopy.

PMID:
14678091
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing
    Loading ...
    Write to the Help Desk