Objective: Postmenopausal bleeding can be a sign of endometrial carcinoma and other endometrial pathologies. Patients underwent transvaginal ultrasonography (TvUSG) for comparison of risk factors of endometrial pathology with results of probe curettage.

Methods: In the present study, TvUSG was performed on 400 patients with postmenopausal bleed-ing and compared with results of probe curettage. The study was conducted retrospectively on patients who were admitted to the İstanbul Okmeydanı Training and Research Hospital clinic be-tween January 2014 and November 2016. Endometrial thickness and biopsy results were compared among patients with an endometrial thickness of >4 mm. Correlation between endometrial thickness and menopausal age; body mass index; diabetes mellitus; hypertension; smoking; age; parity; number of postmenopausal bleeding episodes; reproductive period; family history of colon, endometrial, and ovarian cancer; use of hormone replacement therapy, tamoxifen, oral contraceptive, and intrauterine device (IUD); gravidity; and age at menarche was evaluated statistically.400 patients divided into2 groups according to patholohy results. Group1: Proliferative endometrium, secretory endometrium, endometrial polyp, simple atypical endometrium, endometritis, atrophic endometrium. Group2: Complex atypical hyperplasia, adenocarcinoma Ethical committee approval is taken from Okmeydanı Training and Research Hospital.

Results: The distribution of the 400 women according to histological diagnosis was as follows: proliferative endometrium, 110 (27.5%); atrophic endometrium, 155 (38.8%); endometrial polyp, 65 (16.3%); adenocarcinoma, 40 (%10), simple atypical hyperplasia 15 (3.8%), complex atypical endometrial hyperplasia, 5 (1.3%); endometritis, 5 (1.3%); and secretory endometrium, 5 (1.3%). Histopathology distribution according to endometrial thickness was as follows: atrophic endometrium, 6.44±2.23; secretory endometrium, 8±0; proliferative endometrium, 8.9±3.7; endometrial polyp, 12±5.16; endometrial hyperplasia, 5.9±1.6; atypical endometrial hyperplasia, 20± 0; and adenocarcinoma, 12.75±4.43. During the reproductive period, endometrium thickness and endometrium cancer in the family history in Group 2 and parity; time to first bleeding; smoking; and use of tamoxifen, oral contraceptive, and IUD in Group 1 were statistically significant. The other risk factors were not significant.

Conclusion: Endometrial thickness measurement with TvUSG provides prior knowledge of post-menopausal bleeding. Endometrial curettage is the gold standard treatment.