The optimal endometrial thickness threshold for prediction of endometrial cancer in postmenopausal women without bleeding remains uncertain-Systematic review and meta-analysis.

The incidental finding of endometrial thickness (ET) >4 mm in the absence of postmenopausal bleeding (PMB) is a common cause of referring women to secondary care. However, there is lack of consensus amongst gynecologists as regards the management. It is estimated that up to 15 % of endometrial cancers occur in women without PMB.

Caesarean section operation is not associated with myometrial hypertrophy-a prospective cohort study.

Maternity statistics of England in 2020 showed rise in Caesarean Section (CS) rate to 31%. Some studies correlated adverse gynaecological symptoms e.g.

Folic acid supplementation in postmenopausal women with hot flushes: phase III randomised double-blind placebo-controlled trial.

Objective: To assess whether folic acid supplementation ameliorates hot flushes.

Design: Double-blind, placebo-controlled randomised trial.

Setting: Nine hospitals in England.

Black women with postmenopausal bleeding have lower prevalence of endometrial cancer than other ethnic groups.

Modern medical practice strives for a personalized approach to patient care. The evidence regarding the prevalence of endometrial cancer in various ethnic groups is scarce and conflicting. This study was conducted to determine this prevalence in postmenopausal bleeding (PMB) women.

Endometrial pathology in recurrent postmenopausal bleeding: observational study of 385 women.

Objectives: Women with recurrent postmenopausal bleeding (PMB) are considered as being at higher risk for endometrial hyperplasia and cancer, and guidelines suggest offering hysterectomy in unexplained cases with repeated negative investigations. This study aims to determine the prevalence of endometrial pathology in women referred with recurrent PMB to help inform clinical practice.

Methods: This was an observational study of prospectively collected data over a 5-year period, including 1902 women referred to the PMB clinic.

Predictors of malignancy in endometrial polyps: study of 421 women with postmenopausal bleeding.

Objective: There is lack of consensus as whether benign-looking endometrial polyps should be removed in postmenopausal women. To help inform clinical practice, this study was conducted to quantify the prevalence and identify the predictors of hyperplasia and cancer in polyps.

Methods: The data of 2625 consecutive women attending a postmenopausal bleeding clinic were collected prospectively in a UK teaching hospital between January 2011 and December 2015.

Caesarean section scar causes myometrial hypertrophy with subsequent heavy menstrual flow and dysmenorrhoea.

In the recent years, maternity statistics world-wide show a continuous rise in the rate of Caesarean Section (CS) operation. Many CS deliveries are conducted despite having no clear obstetric indications. The CS scar is assumed to be related to many adverse clinical gynaecological symptoms such as intermenstrual bleeding, dysmenorrhoea, dyspareunia and chronic pelvic pain; however, the mechanism of this relation is not clear.

Is routine adnexal scanning for postmenopausal bleeding of value? Observational study of 2101 women.

Our objective is to assess the merits of adnexal scanning during the investigation of women with postmenopausal bleeding (PMB) in terms of adnexal cancer diagnosis. This observational study was designed utilising an institutional PMB database in a teaching hospital, analysing a sample of 2101 consecutive women with PMB seen between 16th February 2012 and 12th August 2014 looking at the prevalence of cancer in adnexal masses identified on Trans-vaginal ultrasound scanning (TVS) in these PMB women. This study suggests that routine adnexal scanning in women with PMB may provide no benefit.

Ovarian Mature Cystic Teratoma: Challenges of Surgical Management.

Although ovarian mature cystic teratomas are the commonest adnexal masses occurring in premenopausal women, there are many challenges faced by gynecologists on deciding upon the best surgical management. There is uncertainty, lack of consensus, and variation in surgical practices. This paper critically analyzes various surgical approaches and techniques used to treat these cysts in an attempt to outline a unified guidance.

Outpatient 'Acute Gynaecology Clinic' - a novel admission avoidance model to improve women care.

This article presents to the gynaecologists, general practitioners, accident and emergency doctors and the policy makers the concept, proposed set-up and the benefits of the outpatient consultant-delivered 'Acute Gynaecology Clinic' as a novel admission avoidance model to improve women care and satisfaction. The service caters for women who present with urgent benign non-pregnancy-related gynaecological conditions not severe enough to necessitate admission or immediate assessment.

Cattle Uterus: A Novel Animal Laboratory Model for Advanced Hysteroscopic Surgery Training.

In recent years, due to reduced training opportunities, the major shift in surgical training is towards the use of simulation and animal laboratories. Despite the merits of Virtual Reality Simulators, they are far from representing the real challenges encountered in theatres. We introduce the "Cattle Uterus Model" in the hope that it will be adopted in training courses as a low cost and easy-to-set-up tool.

Non-hormonal topical treatment of vulvovaginal atrophy: an up-to-date overview.

Vulvovaginal atrophy-related symptoms exert a negative impact on the quality of life of up to 50% of postmenopausal women. Many of them decline to use topical vaginal estrogen, which is the standard effective therapy, due to the adverse publicity over recent years, and seek for alternatives. Further, there are no safety studies to support the use of topical vaginal estrogen in breast cancer survivors, and it is considered as contraindicated by many health-care professionals.

Use of levonorgestrel-releasing intrauterine system in the prevention and treatment of endometrial hyperplasia.

Endometrial hyperplasia is a commonly seen gynecological condition that affects women of all age groups. Whereas hysterectomy is the most preferred treatment option for complex endometrial hyperplasia with atypia, there is no consensus regarding the first-line management of women with hyperplasia without cytological atypia. Oral progestogen therapy was used with some success.

Endometrial hyperplasia - the dilemma of management remains: a retrospective observational study of 280 women.

Objective: To quantify the rate of inconsistency in histopathological reporting between endometrial biopsy specimens (obtained by Pipelle endometrial sampler or curettage) and hysterectomy specimens using the World Health Organization classification criteria.

Study Design: A retrospective review of the records of 280 women with a histopathological diagnosis of endometrial hyperplasia treated in Ipswich Hospital NHS Trust, UK from 1 January 1998 to 31 May 2009.

Results: Discrepancy was found between the histopathological results of endometrial samples and hysterectomy specimens.

Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick?

Postmenopausal estrogen deprivation has been suggested as a risk factor for lower urinary tract dysfunction including stress incontinence, overactive bladder and recurrent urinary tract infection. These symptoms could have enormous effects on individuals and health-care providers in terms of impact on quality of life and cost. Recent randomized, controlled trials suggested that systemic hormone replacement therapy does have a negative effect on female lower urinary tract function, probably because of the progestogen component.