Operative Hysteroscopy Doesn't Cut Postmenopausal Bleeding

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Operative Hysteroscopy Doesn't Cut Postmenopausal Bleeding
Operative Hysteroscopy Doesn't Cut Postmenopausal Bleeding

MONDAY, June 6, 2016 (HealthDay News) -- Operative hysteroscopy does not reduce recurrent bleeding in women with postmenopausal bleeding (PMB), thickened endometrium, and benign endometrial sampling, according to a study published online May 26 in BJOG: An International Journal of Obstetrics and Gynaecology.

Nehalennia van Hanegem, M.D., from the Academic Medical Center in Amsterdam, and colleagues conducted a multicenter trial involving women with PMB, an endometrial thickness of >4 mm, and benign result from endometrial sampling. Participants were randomized to hysteroscopy (98 women) or expectant management (102 women).

The researchers found that 15.3 percent of the hysteroscopy group and 18.0 percent in the expectant management group experienced recurrent bleeding within one year (relative risk, 0.85; 95 percent confidence interval, 0.46 to 1.59). Fifty-one percent of patients in the hysteroscopy group were diagnosed with polyps; 6 percent showed evidence of endometrial (pre)malignancy. Three women were found to have hyperplasia with atypia and three women had endometrial cancer in final pathology results after hysterectomy.

"In women with PMB, a thickened endometrium and benign endometrial sampling, we did not find a significant reduction in recurrent bleeding after operative hysteroscopy," the authors write. "The finding of a 6 percent prevalence of (pre)malignancy in an endometrial polyp, not diagnosed by blind endometrial sampling, indicates that intracavity diagnostics should become a standard procedure in these women."

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