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An unnecessary ouch: is routine outpatient endometrial sampling indicated where hysteroscopy reveals an atrophic cavity?
AbstractThere is currently little guidance in the literature as to whether routine endometrial sampling is indicated after a normal or atrophic cavity has been visualised at outpatient hysteroscopy for post-menopausal bleeding. Retrospective electronic database review of women with post-menopausal bleeding attending an outpatient hyster-oscopy clinic was performed. Seventy-nine patients underwent outpatient hysteroscopy for post-menopausal
bleeding. Forty-four of these (56 %) were found to have normal or atrophic cavities with no other visible patholo-gies. Forty of these women (89 %) underwent endometrial
sampling. Thirty of those sampled (75 %) had an inter-pretable sample showing a normal or atrophic endometri-um on histology, and ten were reported as inadequate for analysis. There were no reports of abnormal histology in this cohort. Routine endometrial sampling at outpatient hysteroscopy where the cavity has been visualised as normal or atrophic did not reveal any unexpected pathol-ogy. It may be possible to omit this painful procedure, but further larger studies are required.
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