The complexity of diagnosing endometrial pathology in postmenopausal women using a clinical case example

Pathological processes of the endometrium represent an extensive group of diseases that require special vigilance. In practice, unjustified invasive interventions are often observed in elderly patients, which leads to a search for an approach to routing and treating postmenopausal women undergoing intrauterine interventions. The purpose of this article is to study the management tactics of postmenopausal patients with endometrial pathology. Materials and methods. The analysis of data from domestic and foreign literature and guidelines, as well as the medical history of 1 patient, was carried out on the basis of the gynecological department of the CHUZ KB RZD-Medicine Samara. Results. A patient with a comorbid background and a long postmenopausal period (>15 years) underwent hysteroscopy with suspected uterine polyp, which revealed intrauterine synechiae. After 3 days, according to transvaginal ultrasound, hematometer complications with a suspected fibrin clot were detected. Conclusions. This clinical case highlights the limited possibilities of ultrasound diagnostics in detecting focal changes in conditions of atrophic endometrium. Management tactics for postmenopausal patients with endometrial pathology should be based on the clinical picture, individual risk, and expediency of intervention. In the absence of symptoms and the presence of small formations, it is possible to choose a wait-and-see approach with regular ultrasound and pipel biopsy, avoiding unnecessary invasive procedures.