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Management of postmenopausal bleeding in Sweden: a need for increased use of hydrosonography and hysteroscopy.

Epstein, Elisabeth LU (2004) In Acta Obstetricia et Gynecologica Scandinavica 83(1). p.89-95
Abstract
Background. The objective was to determine how postmenopausal bleeding (PMB) is managed in Sweden today, and to relate the findings to a new evidence-based algorithm for the management of PMB.



Methods. A questionnaire regarding the role of ultrasound and the use of different endometrial biopsy methods in the management of PMB was sent to all 61 gynecologic departments in Sweden.



Results. Fifty-nine of the 61 departments (97%) satisfactorily answered the questionnaire. Ultrasound was either always (n = 54, 92%) or most commonly (n = 5, 8%) used in the diagnostic work-up of PMB. In women with endometrial thickness <=4 mm, 18 of the departments (31%) routinely sampled the endometrium; 12 (15%) followed... (More)
Background. The objective was to determine how postmenopausal bleeding (PMB) is managed in Sweden today, and to relate the findings to a new evidence-based algorithm for the management of PMB.



Methods. A questionnaire regarding the role of ultrasound and the use of different endometrial biopsy methods in the management of PMB was sent to all 61 gynecologic departments in Sweden.



Results. Fifty-nine of the 61 departments (97%) satisfactorily answered the questionnaire. Ultrasound was either always (n = 54, 92%) or most commonly (n = 5, 8%) used in the diagnostic work-up of PMB. In women with endometrial thickness <=4 mm, 18 of the departments (31%) routinely sampled the endometrium; 12 (15%) followed the women with ultrasound; three (5%) did both sampling and follow-up with ultrasound; and the remaining 29 (49%) used expectant management (i.e. no biopsy or routine follow-up). In women with endometrium >=5 mm, hydrosonography was performed routinely in two departments (3%), occasionally in 37 departments (63%), and never in 20 departments (34%). In women with endometrium >=5 mm, endometrial biopsy was obtained routinely by Endorette®/Pipelle® in 39 departments (66%), while in 26 departments (44%) operative hysteroscopy was never performed.



Conclusion. More than one-third of the gynecologic departments in Sweden never perform hydrosonography to rule out focal lesions or operative hysteroscopy for the removal of such lesions. Hydrosonography and hysteroscopy have a central role in the new guidelines for the management of PMB. Therefore, a need exists to broaden the use of hydrosonography and hysteroscopy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Obstetricia et Gynecologica Scandinavica
volume
83
issue
1
pages
89 - 95
publisher
Wiley-Blackwell
external identifiers
  • wos:000187243500014
  • pmid:14678091
  • scopus:1642512363
ISSN
1600-0412
DOI
10.1111/j.1600-0412.2004.00357.x
language
English
LU publication?
yes
id
789bbd7c-40a5-485f-bbe6-04668281eb47 (old id 119585)
date added to LUP
2007-07-18 15:56:44
date last changed
2017-02-12 04:06:40
@article{789bbd7c-40a5-485f-bbe6-04668281eb47,
  abstract     = {Background. The objective was to determine how postmenopausal bleeding (PMB) is managed in Sweden today, and to relate the findings to a new evidence-based algorithm for the management of PMB.<br/><br>
<br/><br>
Methods. A questionnaire regarding the role of ultrasound and the use of different endometrial biopsy methods in the management of PMB was sent to all 61 gynecologic departments in Sweden.<br/><br>
<br/><br>
Results. Fifty-nine of the 61 departments (97%) satisfactorily answered the questionnaire. Ultrasound was either always (n = 54, 92%) or most commonly (n = 5, 8%) used in the diagnostic work-up of PMB. In women with endometrial thickness &lt;=4 mm, 18 of the departments (31%) routinely sampled the endometrium; 12 (15%) followed the women with ultrasound; three (5%) did both sampling and follow-up with ultrasound; and the remaining 29 (49%) used expectant management (i.e. no biopsy or routine follow-up). In women with endometrium &gt;=5 mm, hydrosonography was performed routinely in two departments (3%), occasionally in 37 departments (63%), and never in 20 departments (34%). In women with endometrium &gt;=5 mm, endometrial biopsy was obtained routinely by Endorette®/Pipelle® in 39 departments (66%), while in 26 departments (44%) operative hysteroscopy was never performed.<br/><br>
<br/><br>
Conclusion. More than one-third of the gynecologic departments in Sweden never perform hydrosonography to rule out focal lesions or operative hysteroscopy for the removal of such lesions. Hydrosonography and hysteroscopy have a central role in the new guidelines for the management of PMB. Therefore, a need exists to broaden the use of hydrosonography and hysteroscopy.},
  author       = {Epstein, Elisabeth},
  issn         = {1600-0412},
  language     = {eng},
  number       = {1},
  pages        = {89--95},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Management of postmenopausal bleeding in Sweden: a need for increased use of hydrosonography and hysteroscopy.},
  url          = {http://dx.doi.org/10.1111/j.1600-0412.2004.00357.x},
  volume       = {83},
  year         = {2004},
}