Management of postmenopausal bleeding in Sweden: a need for increased use of hydrosonography and hysteroscopy.
(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)
Please use this url to cite or link to this publication:
http://lup.lub.lu.se/record/119585
- author
- Epstein, Elisabeth LU
- organization
- publishing date
- 2004
- 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
- 2018-01-07 09:02:34
@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 <=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.<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},
}