Dr Shivani Agarwal, Dr Uma Singh, Dr Suman Lata Mendiratta


Postmenopausal bleeding (PMB) requires prompt exclusion of malignancy for reduction of morbidity and mortality risks. A screening method with high specificity and sensitivity would prevent invasive procedure and aid in accuracy. The objective of present study was to evaluate the role of Transvaginal ultrasound (TVS), Saline Infusion Sonohysterography (SIS) and Hysteroscopy (HS) in diagnosis of PMB.

A total of 37 women with PMB attending gynecology OPD in Kasturba Hospital were enrolled and subjected to TVS, SIS and HS. Results were compared with histopathology as gold standard. The most frequent cause of PMB was endometrial polyp (29.7%) followed by endometrial hyperplasia (24.3%), endometrial atrophy (21.6%), submucous myoma (13.5%) and endometrial carcinoma (10.8%). Overall sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) of TVS was found to be 78.6%, 92.6%, 73.7% and 92.3% respectively but that of SIS and hysteroscopy were 82.4%, 94.3%, 74.6%, 94.1 and 82.7%, 96.9%, 81.2%, 94.2% almost at par respectively. TVS extended to SIS whenever required is recommended to be the preliminary investigation of choice in PMB.


TVS, SIS, Hysteroscopy, Postmenopausal bleeding

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