OBJECTIVE: In our study, we compared the results of the hysterescopy and dilatation and currettage (D&C) of the postmenopausal patients with uterin bleeding and endometrial thickness. Institution: Medical Faculty of Ege University, Department of Obstetrics and Gynecology, IZMIR. MATERIAL-METHODS: In our propective study, hysterescopy was performed to136 postmenopausal patients who applied to our clinic with symptoms of the uterin bleeding and endometrial thickness. After hysterescopy, D&C was performed to all patients. If the intracavitary pathology could not be removed with D&C, hysterescopy was performed again and intracavitary pathology was removed with hysterescopy. The accurate results of the endometrial sampling were determined with hystopathologic evaluation and these results are compared with hysterecopy. RESULTS: The hysterescopy revealed normal cavity in 74 patients (54%) and intracavitary pathology (polyp, hyperplasia, malignancy, endometrittis) in 62 (%46) patients. 72 (%97) of 74 patients with normal cavity (atrophic endometrium, functional endometirum) on hysterescopy were confirmed by hystopathologic evaluation. The histopathologic results of the remaning 2 patients were endometrial hyperplasia and endometrittis. 43 (%69) of 62 patients with intracavitary pathology on hysterescopy were confirmed by hystopathologic evaluation. The sensitivity, specificity, positive and negative predictive values for detection of intracavitary pathology by hysterescopy were 95.9%, 82%, 75.8%, 97.2%, respectively. These values for detection of polyps and hyperplasia by hysterescopy were 100%, 94.4%, 81.8%, 100% and 93.3%, 89.2%, 51.8%, 99%, respectively. CONCLUSION: The determined rate of the intracavitary pathology using the hysterescopy was high, espaciallly for polyps. Sometimes, the diagnosis of the hyperplasia and malignancy could be overlooked with hysterescopy. Therefore, D&C must be performed not to overlooked the focal malignancy patients.

Keywords: Postmenopausal vaginal bleeding postmenopausal endometrial thickness hysteroscopy dilatation and curretage