Post Menopause Spotting

My wife recently had some spotting.  She had her annual exam and her gynecologist did a biopsy, pap smear and had her get an ultrasound.  I believe the biopsy came back benign but the ultrasound showed some water or liquid.  The gynecologist thought it might just be from the biopsy so she is having another ultrasound tomorrow.  The spotting occurred about 3 weeks ago.  However, just yesterday she again had spotting.  If the ultrasound comes back similar, what are we possibly looking at?  What steps would be next?  Any thoughts would be greatly appreciated.  My wife is very fit, age 58 and went thru menopause pretty early at around age 40.  She was initially on hrt for about 5 years but hasn't been on that for at least 8 years.

[Elaine Brown, MD]

Hi!
From the sound of things, it is quite unlikely that your wife has endometrial cancer.
Other conditions such as fibroids, and polyps can cause similar problems.  If your wife was my patient, and if the ultrasound showed any persistent abnormalities ( good chance it won't)
my next step would be to go to hysteroscopy/d&c.  In this procedure, a fibre optic camera can be inserted into the uterus to take a look around in there, and if necessary, do directed biopsies.  Some doctors can do a similar procedure known as a saline ultrasound in the office.
Good luck!
Dr B

[Jasonfree222]

Thanks.  She had her ultrasound yesterday and should have the results early next week.  If as you suspect it won't shoe any persistent abnormailities, would the next step be the hysteroscopy/d&c?  Since she had spotting again and if it is fibroids or polyps how do you find and remove them?  Is it surgery or in office procedure?