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.