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Asymptomatic postmenopausal women with sonographically thickened endometrium. What do we do?

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DOI: 10.4236/ojog.2013.38114    5,721 Downloads   7,829 Views   Citations

ABSTRACT

Background: A thickened endometrium in the postmenopausal patient is a common reason for referral to gynaecology rapid access clinics under the cancer targets wait. This can often be an incidental finding in the asymptomatic patient. Investigation of this can be invasive, uncomfortable and carries significant surgical risk. Aims: This paper aims to summarise all the recent literature to see if there is any clear consensus on who should be further investigated in this select group of patients. Methods: Systematic literature review. Results: The studies varied greatly on the need for further investigation in asymptomatic women with endometrial thickness greater than 11 mm, with some deciding on careful case selection for further investigation, and others investigating every patient. The treatment of asymptomatic patients with endometrium classified as thickened, yet under 11 mm and no symptoms again varied in case selection and further investigation. Endometrial polyps were mentioned in 1 paper, suggesting that asymptomatic polyps need not be removed, which is contrary to current clinical practice. Conclusion: There is no overall opinion as to the exact treatment of women with thickened endometrium. Women should be carefully triaged and all other factors taken into account before further investigation are instigated.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Sathiyathasan, S. , Jeyanthan, K. and Khoo, C. (2013) Asymptomatic postmenopausal women with sonographically thickened endometrium. What do we do?. Open Journal of Obstetrics and Gynecology, 3, 631-633. doi: 10.4236/ojog.2013.38114.

References

[1] Schmidt, T., Breidenbach, M., Nawroth, F., Mallmann, P., Beyer, I.M., Fleisch, M.C. and Rein, D.T. (2009) Hysteroscopy for asymptomatic postmenopausal women with sonographically thickened endometrium. Maturitas, 62, 176-178.
[2] Curcic, A., Durdevic, S., Mladenovic-Segedi, L., Grujic, Z. and Visnjevac, N. (2009) Ultrasound in screening of endometrial carcinoma in asymptomatic postmenopausal women. Medicinski Pregled, 62, 263-267.
[3] SOGC Clinical Practice Guideline, No. 249, 2010.
[4] Gambacciani, M., Monteleone, P., Ciaponi, M., Sacco, A. and Genazzani, A.R. (2004) Clinical usefulness of endometrial screening by ultrasound in asymptomatic postmenopausal women. Maturitas, 48, 421-424.
[5] Hartman, A., Wolfman, W., Nayot, D. and Hartman, M. (2013) Endometrial thickness in 1500 asymptomatic postmenopausal women not on hormone replacement therapy. Gynecologic and Obstetric Investigation, 75, 191-195. http://dx.doi.org/10.1159/000347064

  
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