The role of endometrial thicknesses as risk factor in endometrial pathologies

Abstract

Aim: This study aimed to investigate the role of endometrial thickness in endometrial pathologies and compare transvaginal ultrasonography (TvUSG) and histopathological results in pre-and post-menopausal women with abnormal uterine bleeding. Methods: We retrospectively reviewed the records of 1882 women with abnormal uterine bleeding between 2018 and 2020. After exclusions, the final study population consisted of 1088 women. The primary variable was the endometrial thickness. Secondary variables examined were final diagnosis, age, gravidity, parity, and menopausal status. Results: Results for 653 women (60.0%) with normal endometrium, 26 women (2.4%) with endometrial carcinoma, and 409 women (37.6%) with other endometrial pathology were analyzed. The mean endometrial thickness of the women with normal endometrium was 11.38±5.80 mm (range: 3-45 mm), while the mean endometrial thickness of the women with other endometrial pathology and endometrial carcinoma were 12.27±5.15 mm (range: 3-33 mm), and 17.24±7.19 mm (range: 5-33 mm), respectively. A statistically significant difference was detected between the groups concerning endometrial thickness (F=15.464, p<0.001). On the other hand, logistic regression analysis was used to identify the risk factors for endometrial carcinoma. Age (p=0.003) and endometrial thickness (p=0.002) were the risk factors in predicting endometrial carcinoma. Conclusion: Women admitted to the hospital with pre-menopausal or post-menopausal bleeding should undergo a detailed gynaecological examination, and the endometrium should be evaluated with TvUSG. If an increased endometrial thickness is detected, an endometrial biopsy should be performed. Even TvUSG is not a definitive diagnostic method; it is a non-invasive, cost-effective, and guiding technique for endometrial pathologies.