Possibilities and limits of contact hysteroscopic assessment of the causes of postmenopausal bleeding

: In this study, the contact-hysteroscopic findings are compared with the histopathological diagnosis of 168 patients who were treated for post-menopausal bleedings. The good diagnostic agreement between contact-hysteroscopy and histopathology in mostly benign alterations like atrophic endometrium (94.7%), polyposis (87.5%), mucosal polyps (88%) and myomas (100%) is not achieved in precancerous (77%) and cancerous (75%) lesions. Being an optical method, contact hysteroscopy necessarily fails in the evaluation of origin, dignity and degree of differentiation of malign lesions, and is no substitute for a histopathological diagnosis. Therefore, contact hysteroscopy may only provide additional information to dilatation and curettage and thus optimize results and diagnostic security.