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May 12, 1999

Endovaginal Ultrasound to Evaluate Endometrial Abnormalities

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(18):1693. doi:10.1001/jama.281.18.1693

To the Editor: Dr Smith-Bindman and colleagues1 report the results of a meta-analysis evaluating the role of endovaginal ultrasound (EVUS) in excluding endometrial cancer and other endometrial abnormalities. The other endometrial abnormalities include endometrial polyps and submucous leiomyomata, both common causes of postmenopausal bleeding. We agree that using an endometrial thickness threshold of 5 mm results in a high sensitivity and specificity for endometrial cancer. We believe that using EVUS alone is not adequate to exclude benign causes of postmenopausal bleeding and routinely perform hysterosonography in these patients.2