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.

Re-intervention and patient satisfaction rates following office radiofrequency endometrial ablation: a comparative retrospective study of 408 cases.

This retrospective study assessed the efficacy and long-term satisfaction of radiofrequency endometrial ablation outside the context of clinical trials in 408 women, and compared the outcome between office-setting (211, 52%) and day-case procedures under general anaesthetics (197, 48%). The Kaplan Meir time-to-event analysis showed that the cumulative number of women undergoing surgical re-intervention was 32 with a probability of 9.4% (95% CI: 6.

Office hysteroscopic morcellation service: Evaluation of women experience and factors affecting satisfaction.

Objectives: To evaluate the hysteroscopic morcellation service in office-setting in everyday practice outside the context of clinical trials. The primary objectives were to assess level of acceptability and factors affecting women satisfaction. The secondary objectives included assessment of complete resection rate, complications rate, pain score during the procedure and on discharge, and the correlation between the lesion size as subjectively estimated by the hysteroscopists versus the volume of morcellated tissues as semi-quantitively measured by the laboratory.

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.

Thickened endometrium in asymptomatic postmenopausal women - determining an optimum threshold for prediction of atypical hyperplasia and cancer.

There is a lack of consensus about the significance and the management of an incidental finding of endometrial thickness (ET) > 4 mm on transvaginal ultrasound scans in postmenopausal women without postmenopausal bleeding (PMB). The data of 1995 consecutive women attending PMB clinic were collected prospectively; of them 81 (4.1%) were referred because of ET >4 mm without PMB.

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.

PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages - a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation.

Background And Objectives: Progesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question.

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.

A Randomized Trial of Progesterone in Women with Recurrent Miscarriages.

Background: Progesterone is essential for the maintenance of pregnancy. However, whether progesterone supplementation in the first trimester of pregnancy would increase the rate of live births among women with a history of unexplained recurrent miscarriages is uncertain.

Methods: We conducted a multicenter, double-blind, placebo-controlled, randomized trial to investigate whether treatment with progesterone would increase the rates of live births and newborn survival among women with unexplained recurrent miscarriage.

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.