Relationship between Transvaginal Ultrasound Endometrial Volume, Body Mass Index and Endometrial Pathology in Women with Postmenopausal Bleeding

Abstract

ostmenopausal bleeding (PMB) is defined as bleeding occurring in a menopausal woman at least 1 year after cessation of cycles. It must always be investigated because many causes are premalignant or malignant lesions like hyperplasia with atypia and endometrial carcinoma. Various patient characteristics, risk factors and imaging modalities make the diagnosis of a malignant lesion more likely and hence these patients would require an expedited approach for a pathological diagnosis to improve treatment outcomes. 4 to 11 percent of postmenopausal women will experience bleeding and accounts for five percent of gynecology office visits. Many women are confused especially in the early years after menopause about bleeding: whether it is postmenopausal bleeding or continuity of irregular menses after long periods of amenorrhea preceding menopause. Postmenopausal bleeding carries the risk of endometrial cancer or atypia and should be thoroughly investigated. According to a recent study in Egypt, uterine cancer showed the highest urban-rural incidence rate ratio (IRR:6.07; 95% CI: 4.17, 8.85) and also the highest urban incidence in the oldest age group (>70 yrs age category; IRR: 14.39; 95% CI: 4.24, 48.87) in comparison to cervical, breast and ovarian cancers.