Postmenopozal vajinal kanamalı hastalarda endometrium kalınlığı ile probe küretaj sonuçlarının karşılaştırılması

Amaç: Postmenopozal vajinal kanama ile başvuran ve hormon replasman tedavisi almayan hastalarda endometrial kalınlığın ölçülerek probe küretaj sonuçları ile karşılaştırılması. Materyal ve Metod: Herhangi bir menopoz tedavisi almayan ve postmenopozal vajinal kanama şikayeti ile başvuran 120 hastaya jinekolojik muayene ve vajinal ultrasonografi yapılarak endometrial kalınlık ölçüldü. Takiben her hastaya genel anestezi altında probe küretaj yapıldı ve sonuçlar değerlendirildi. Bulgular: Postmenopozal vajinal kanama şikayeti ile gelen 120 hastanın ortalama endometrium kalınlığı 4.7±0.2 mm idi. Probe küretaj sonuçlarında ise 73 (% 60.8) hastada atrofik endometrium, 20 (% 16.7) hastada yetersiz endometrium, 10 (% 8.3) hastada proliferatif endometrium, 5 (% 4.2) hastada endometrial polip, 10 (% 8.3) hastada basit endometrial hiperplazi, 2 (% 1.7) hastada atipi gösteren endometrial hiperplazi görüldü. Sonuç: Postmenopozal vajinal kanama ile başvuran her hastaya 5 mm'nin endometrial kalınlık tespit edilse bile mutlaka probe küretaj yapılmalıdır. Böylece premalign bir lezyon olarak kabul edilen hiperplazi olguları da gözden kaçmamış olacaktır.

Anahtar Kelimeler:

Postmenopoz, Kanama, Ultrasonografi, Endometriyum, Küretaj

Comparison of endometrial thickness and probe curettage results in patients with postmenopausal vaginal bleeding

Objective: To compare endometrial probe curettage results with sonographic endometrial thickness in women with postmenopausal uterine bleeding were not given hormone replacement therapy. Materials and Methods: One hundred twenty patients with abnormal uterine bleeding who have never use any hormonal therapy were evaluated with vaginal examination and their endometrial thickness were measured by transvaginal ultrasonography. After these procedures endocervical and endometrial samples were taken in every patient under general anesthesia and results were evaluated. Results: Mean endometrial thickness was 4.7±0.2 mm in 120 patients with postmenopausal abnormal uterine bleeding. The pathology report confirmed that 73 (% 60.8) patients with atrophie endometrium, 20 (% 16.7) with insufficient material, 10 (% 8.3) with proliferative endometrium, 5 (% 4.2) with endometrial polyp, 10 (% 8.3) with simple endometrial hyperplasia, 2 (% 1.7) with atypical hyperplasia. Conclusion: We conclude that every patient complaining about postmenopausal uterine bleeding must be evaluated with endometrial sampling even if their endometrial thickness less than 5 mm in transvaginal ultrasonographic exam.

Keywords:

Postmenopause, Hemorrhage, Ultrasonography, Endometrium, Curettage,

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