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Menopause

Unsuccessful biopsy

07/05/2006

Question:

I was on hormone replacement therapy for three years. I had a few instances of irregular bleeding. One year ago, I changed my hormone regimen and was taking combined premerin and provera. At that time, I started having more bleeding. My doctor was unable to do an endometrial biopsy in the office and scheduled a D&C with hysteroscopy. He was unable to penetrate the cervix because I have extensive scarring form a cone procedure that was performed years ago. On unltrasound, a large white area is present. My doctor is suggesting hysterectomy mostly to rule out cancer. Are there other alternatives? Thank you so much.

Answer:

That is a difficult situation.  If there is abnormal bleeding and a questionable finding on the ultrasound, it needs to be evaluated.  Unfortunately, our simpler procedures, like endometrial biopsy and D&C did not work in your situation.

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Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati