Stellenwert der Hysteroskopie und fraktionierten Abrasio in der Abklärung von Postmenopauseblutungen

Uterine bleeding occurring in women of postmenopausal age should be considered as the result of malignancies until proved otherwise. The gold standard for the ongoing diagnostic steps of postmenopausal bleedings is still fractional DC 83.5%, 100%, 100% and 74.5% for fractional D&C alone and 96.7%, 100%, 100% and 96.4% for both method combined. With regard to the detection of endometrial polyps, endometrial cancer and myomas alone, the sensitivity and negative predictive value amounted to 98.2, respectively 98.5% for hysteroscopy alone. Conclusion: Through the use of hysteroscopy the number of additional operations due to persisting postmenopausal bleeding was significantly reduced. Today the gold standard for determining the cause of bleeding in postmenopausal women is the combination of hysteroscopy and fractional D&C.