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

Open Journal of Obstetrics and Gynecology, 2013, 3, 631-633 OJOG /10.4236/ojog.2013.38114 Published Online October 2013 (/journal/ojog/) Asymptomatic postmenopausal women with sonographically thickened endometrium. What do we do? Sahathevan Sathiyathasan , K. Jeyanthan, C. L. Khoo * Ealing Hospital, Middlesex, UK * Email: minisathya@ Received 24 August 2013; revised 22 September 2013; accepted 30 September 2013 Copyright ? 2013 Sahathevan Sathiyathasan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding. Endometrial thickness is measured by trans- vaginal ultrasonography (TVUS) and thickening indi- cates an increased risk of hyperplasia or malignancy [1]. The role and significance of endometrial thickness mea- surement by ultrasound in asymptomatic women are un- clear. Background: A thickened endometrium in the post- menopausal 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 sur- gical 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 re- view. 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 en