An 80-year-old woman who experienced bleeding during urination despite no other symptoms besides kidney stones seeks advice on whether to undergo an endometrial biopsy due to a mildly thickened endometrium detected by ultrasound.
Dear Dr. Roach: About three months ago, I bled a bit while urinating. This was the first time in over 30 years since menopause that this happened. An ultrasound was performed, and they found a mildly thickened endometrium with scattered cystic change, but without focal lesion.
Your ultrasound is abnormal; 5 mm is the limit of thickness for a normal endometrium. Getting a biopsy is clearly the recommended procedure, as it gives guidance on the next steps. Still, your risk of uterine cancer is small. You do not have to proceed with the biopsy if you do not want to. If the biopsy shows cancer of the endometrium, surgery is the preferred treatment, but radiation is a possibility for some people.
Conservative management includes rest, ice and physical therapy to help with strength and flexibility. Anti-inflammatory medicines may be helpful. Splinting at nighttime, orthotics, or special shoes are helpful for some people. Prior to considering surgery, experts will consider shockwave treatment, although it’s not clear how effective this is.
Endometrial Biopsy Uterine Cancer Kidney Stones Anesthesia Menopause
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