Introduction
Abnormal uterine bleeding, suspected endometrial polyps, and endometrial
thickness are sources of concern among postmenopausal women and require
tissue biopsy of the endometrial finding.1,2.
Advancements in technique and miniaturized instruments have made it
possible to combine diagnostic and operative hysteroscopy in an
outpatient setting without anesthesia (the “see-and-treat” technique).
This technique, which offers numerous advantages and has gained
increasing popularity in recent years, is particularly relevant to
postmenopausal women, due to the higher rates of comorbidities and
higher risks associated with anesthesia in this age group.
We previously evaluated the accuracy of outpatient hysteroscopy among
peri- and postmenopausal women and showed it to be an adequate and
reliable tool mainly for the evaluation of benign pathology, with a
sensitivity of 93.1%, a specificity of 52.1%, a positive predictive
value of 90.4%, and a negative predictive value of 61% for a visual
diagnosis of any pathology3.
The present study focused on women 70 years and older, given the
combination of higher risks of anesthesia and the higher rates of
clinically significant findings in that group.
The aim of this study is to
characterize both office hysteroscopy and operating room (OR)
hysteroscopy for the diagnosis of endometrial pathologies. In addition,
we aimed to illustrate trends in the utility of hysteroscopy techniques
and in the yield of abnormal findings in this age group over a period of
7 years.