Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Postmenopausal bleeding (PMB) accounts for 5% of all gynecologic office visits. PMB must always be investigated because many causes may be premalignant or malignant. The current study is designed to determine the relationship between endometrial volume as measured by three- dimensional ultrasound imaging and the histopathological findings in the endometrium in women with postmenopausal bleeding and endometrial thickness more than 6mm. Results: Examination of the D&C samples revealed hyperplasia of the endometrium in 77 patients, atrophic endometrium in 17 patients and endometrial carcinoma in 6 patients. Hyperplasia was of simple type in 56 patients and of the complex type in 21 patients. The mean endometrial thickness was 12.3 cm ±5.77, minimum 6 (maximum was 36 mm), the mean endometrial volume was 9.84 ±20.8 (minimum 1.58 and maximum 140.5 cm3). The mean endometrial thickness in patients with endometrial carcinoma was 26.46±8.98 while in the non-malignant patient was 11.39 ± 4.00. This difference was significant statistically (P<0.01). The mean endometrial volume in the carcinoma group was 69.69±61.22 while in the non-tumorous patients it was 6.02 ± 3.63. This difference was also statistically significant (P<0.01). Conclusion: Endometrial volume was significantly different when used to compare between atrophic endometrium, benign endometrial pathology (endometrial hyperplasia and endometrial atrophy), and endometrial carcinoma (P < 0.001). further studies are needed to determine the exact cutoff value in those patients

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