PhD Defence Albertine Johanna Vroom- Pielkenrood

Keywords: Postmenopausal bleeding, Diagnostic pathways, Saline contrast sonohysterography, Counseling strategy 
 

"Diagnostic challenges in postmenopausal bleeding"

This thesis focused on the diagnostic work-up for women with abnormal bleeding after menopause, also called postmenopausal bleeding. Research in this thesis showed that the saline contrast sonohysterography (an ultrasound combined with waterinfusion to detect polyps in the uterus) appeared to be an accurate, minimal invasive test which can be used to determine the further diagnostic work-up in women with postmenopausal bleeding. The randomized trial in this thesis showed that the saline contrast sonohysterography can be performed along the endometrial aspiration biopsy within one out-patient visit instead of two separate visits.  

Both tests are generally performed in the outpatient setting, but it is known that, mainly the endometrial biopsy, can cause severe discomfort. Accurate expectation management could play a crucial role to improve satisfaction for these women. Providing adequate information could be helpful tool. This thesis showed that gynecologist have the impression that women are not sufficiently informed before their first visit, and optimizing the information provision could improve satisfaction. 

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