One-stop clinic for postmenopausal bleeding at district general hospital: does it have a role?

Abstract

A postmenopausal bleeding (PMB) clinic was set up to provide quicker access for consultation, transvaginal ultrasound (TVS) and pipelle endometrial sampling in one visit. The aim of the study was to evaluate the impact of a one-stop PMB clinic on reaching a diagnosis and initiating treatment. One hundred and seven women have been referred to PMB clinic since the service started. We analysed the prospective findings of 80 patients who met the criteria of direct GP referral to PMB clinic. The mean time from GP referral to consultation at PMB clinic was 14.8 days (range: 2-24 days); 97.5% of women had TVS and abnormal findings were reported in 67.5%. Pipelle endometrial sampling was performed in 31 patients and a sample obtained successfully in 21 women. Ten women were referred directly for diagnostic hysteroscopy and another 10 had hysteroscopy after a failed pipelle sampling. Twenty-four women (30%) were discharged back to their general practitioners (GPs) after reassurance by consultation and normal TVS. Seventy women (87.5%) considered a single PMB clinic visit was satisfactory. This study demonstrates the effective role of the one-stop PMB clinic to provide quick reassurance, arrive at a diagnosis and initiate plan of management during a single outpatient visit.