Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/94302
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Type: Journal article
Title: Follow-up of women after a first episode of postmenopausal bleeding and endometrial thickness greater than 4 millimeters
Author: Timmermans, A.
van Doorn, L.
Opmeer, B.
Kroeks, M.
Jitze Duk, M.
Bouwmeester, A.
Kruitwagen, R.
Dijkhuizen, F.
Mol, B.
Citation: Obstetrics and Gynecology, 2008; 111(1):137-143
Publisher: Lippincott Williams & Wilkins
Issue Date: 2008
ISSN: 0029-7844
1873-233X
Statement of
Responsibility: 
Anne Timmermans, Lena C. van Doorn, PhD, Brent C. Opmeer, Maurice V. A. M. Kroeks, M. Jitze Duk, Annette M. Bouwmeester, Roy F. M. P. Kruitwagen, F. Paul H. L. J. Dijkhuizen, and Ben W. J. Mol, for the Dutch Study in Postmenopausal Bleeding, DUPOMEB
Abstract: OBJECTIVE: To estimate the incidence of recurrent postmenopausal bleeding among women who were diagnosed with an endometrial thickness greater than 4 mm. METHODS: We designed a prospective cohort study and included consecutive women not using hormone replacement therapy, presenting with a first episode of postmenopausal bleeding. We evaluated patients who had an endometrial thickness greater than 4 mm at transvaginal ultrasonography and benign endometrial sampling; presence of carcinoma was ruled out by office endometrial sampling, hysteroscopy, and/or dilation and curettage. Time until recurrent bleeding was measured, and diagnosis at recurrent bleeding was recorded. RESULTS: Among 318 patients who had an endometrial thickness greater than 4 mm, 222 patients had benign histology results and were available for follow-up. During follow-up, 47 (21%, 95% confidence interval 16–27%) patients had recurrent bleeding, with a median time to recurrent bleeding of 49 weeks (interquartile range 18 to 86 weeks). There was no difference with respect to recurrence rate between patients with polyp removal, patients with a normal hysteroscopy, and patients with office endometrial sampling alone at the initial workup. Two patients were diagnosed with atypical endometrial hyperplasia upon recurrent bleeding. CONCLUSION: The recurrence rate of postmenopausal bleeding in women with endometrial thickness greater than 4 mm is 20%. This recurrence rate is not related to incorporation of hysteroscopy or polyp removal at the initial workup.
Keywords: Dutch Study in Postmenopausal Bleeding (DUPOMEB); Endometrium; Humans; Metrorrhagia; Recurrence; Hysteroscopy; Follow-Up Studies; Postmenopause; Aged; Middle Aged; Female
Rights: © 2007 by The American College of Obstetricians and Gynecologists.
RMID: 0020136781
DOI: 10.1097/01.AOG.0000296654.43944.e6
Appears in Collections:Obstetrics and Gynaecology publications

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