Abstract
SUMMARY Abnormal uterine bleeding is an important symptom that can mean presence of endometrial cancer or endometrial hyperplasia. The aim of this study is to assess the effectiveness of selected diagnostic methods in peri and potmenopausal women with abnormal uterine bleeding, and to propose a way to manage in these patients. Different diagnostic methods are assessed, which include transvaginal ultrasonography, sonohysterography, Doppler technique, magnetic resonance images, biopsy by Pipelle, dilatation and curettage, and hysteroscopy. It is founded that ultrasonography has a high efficiency when it comes for identifying diffuse lesions, while sonohysterography has a high efficiency for identify focal lesions. On the other hand biopsy by Pipelle has demonstrated to rule out diffuse pathology with a high efficiency. It is concluded that the best way to manage patients with abnormal uterine bleeding by performing ultrasonography and sonohysterography at the same time followed by a Pipelle biopsy. Finally, it can be suggested that by this way it is highly probable that all cases with endometrial carcinoma and endometrial hyperplasia can be identified.
Highlights
Hoy en día dilatación y curetaje (D&C) no es considerado el estándar dorado, por lo que no hay suficientes argumentos para indicar este procedimiento invasivo en todas las pacientes con sangrado uterino anormal
Puede ser inferido que la mejor vía de manejo en estas pacientes es hacer una combinación de métodos diagnósticos con el fin de lograr altas sensibilidades y especificidades en el proceso diagnóstico
Summary
Abnormal uterine bleeding is an important symptom that can mean presence of endometrial cancer or endometrial hyperplasia. It is concluded that the best way to manage patients with abnormal uterine bleeding by performing ultrasonography and sonohysterography at the same time followed by a Pipelle biopsy. 5 a 10% de todas las pacientes postmenopáusicas con sangrado uterino anormal tienen cáncer endometrial, y esta cifra podría alcanzar el 60% en las pacientes de 80 años [1]. Más frecuente en pacientes postmenopáusicas, son las lesiones difusas dentro de las cuales destacan la hiperplasia endometrial y el cáncer endometrial. No es posible proponer este tipo de estudio en todas las pacientes con sangrado uterino anormal debido a que la mayoría de ellas no tienen cáncer endometrial. El objetivo de este estudio es evaluar la eficiencia de diferentes métodos diagnósticos en pacientes peri y postmenopáusicas con sangrado uterino anormal, y proponer una vía de manejo en estas pacientes
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