Indications for diagnostic abrasion cavi uteri and its histopathological results after menopause

The study objective was to quantify the indications for diagnostic abrasion cavi uteri after menopause and analyze its histopathological results.
Material and methods: Menopause was considered if period of amenorrhea was ≥12 months. Either metrorrhagia, as well as abnormal finding during transvaginal ultrasonography constituted an indication for abrasion. Analyzed input factors were metrorrhagia, hyperplasty of endometrium and incidence of fluid in cavum uteri (FCU). Among 290 women seven groups were distinguished as a result of combinations of input factors. Mean age was 60.3±10.7 years, BMI 29.1±4.9 kg/m², parity 1.7±0.8, menarche 13.3±1.7 years, menopause 50.1±3.7 lat, endometrial thickness 10.1±6.9 mm, and fluid diameter 6.2±6.7mm.
Results: Endometrial carcinoma (EC) was diagnosed in 32 (11.0%) subjects. It was more frequent in woman with metrorrhagia (13%), especially with co-existing endometrial hyperplasia (EH, 15,8%). EH as the only abnormal finding resulted in diagnosis of EC in 10.9%. Risk of development of EC was increasing parallel to increase of endometrial thickness. The relative risk for EC was 3.6-fold grater if the thickness was 15-20 mm, and 10.7 fold greater if the thickness was ł20 mm. The incidence of FCU as an alone finding was not associated with increased risk of EC. Single women having FCU has been diagnosed with EC in this study, there was 1 mm endometrial thickness accompanying and extensive
bleeding. The amount of uternal fluid was significantly related to parity, what suggest the mechanic factors involved in fluid retention.
Conclusions: Metrorrhagia after menopause indicates a very severe risk of development of EC. The risk for EC was 20-fold grater compared to general population after menopause. The risk of EC was related to endometrial thickness. Both signs are urgent indication for abrasion cavi uteri. The incidence of FCU does not seem to be a symptom of carcinoma.