Can transvaginal ultrasound detect endometrial disease among asymptomatic postmenopausal patients?

Abstract

Transvaginal ultrasound should not replace endometrial biopsy for detection of endometrial disease among asymptomatic postmenopausal patients. Endometrial biopsy has been considered a standard for the clinical diagnosis of endometrial disease among asymptomatic patients, but it is invasive, may be uncomfortable, and may not be able to be performed for some patients with cervical stenosis. Ultrasound evaluation is less invasive and more comfortable and can be performed for patients with cervical stenosis. The positive predictive value of ultrasound is not adequate to allow it to replace endometrial biopsy for screening of asymptomatic women (strength of recommendation: B, based on cohort studies).