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- Title
A Study of the Role of Hysteroscopy in Abnormal Uterine Bleeding.
- Authors
Garg, Gazal; Patvekar, Meena; Agarwal, Kriti; Bhatia, Ishan; Sanghi, Sahil
- Abstract
Objectives: There were two study objectives: (1) to determine the diagnostic accuracy of hysteroscopy in women with abnormal uterine bleeding (AUB) and (2) to correlate hysteroscopic and histopathologic findings in patients who had AUB. Materials and Methods: This prospective longitudinal study was conducted at the Dr. D.Y. Patil Medical College, Hospital & Research Centre, in Pimpri, Pune, India, from April 2015 to November 2016. The study included 60 patients who came to the outpatient department with complaints of AUB. The patients were admitted 1 day before the procedure, after they each signed informed consent forms for participation in the study. The patients did not require anesthesia; a 2.9-mm hysteroscope was used, with normal saline as the distending media. Results were recorded on a prescribed proforma. The patients then underwent dilatation and curettage and the endometrial sample tissues were sent for histopathologic examination. The correlation between findings on hysteroscopy and histopathologic examination was tabulated. Results: Among the 60 patients who had AUB, 40 % were between 46-55 years. Menorrhagia was seen in 43% of the cases ( n = 26) of patients, followed by polymenorrhagia and postmenopausal bleeding in 23.3% ( n = 14) and 13.33% ( n = 8) of the cases, respectively. Endometrial polyps were the most common cause of AUB, comprising 26.67% (n = 16) of total cases, followed by submucus myomas attributing to 23.33% ( n = 14) of the cases. Functional endometrium with a normal appearance was seen in 18.33% the cases ( n = 11), followed by endometrial hyperplasia in 11.66% (n = 7) and retained products of conception in 6.67% ( n = 4) of the cases, whereas endometritis and adenomysosis was present in 5% ( n = 3) and 3.33% ( n = 2) of the cases, respectively. The sensitivity of hysteroscopy was 100% for endometrial polyps, whereas specificity was 95%. Hysteroscopy was 100% sensitive and specific for submucous myomas, endometrial atrophy, endometrial carcinomas, retained products of conception, and intrauterine adhesions; was least sensitive for endometrial hyperplasia (54.55%); and was 97.96% specific for endometrial hyperplasia. Conclusions: The diagnostic accuracy of hysteroscopy, compared with histopathology was 100% for most intrauterine pathologies but was only 71% for endometrial hyperplasia, mandating a need to combine endometrial sampling with diagnostic hysteroscopy in cases with high risk of hyperplasia. (J GYNECOL SURG 33:226)
- Subjects
INDIA; RESEARCH evaluation; METRORRHAGIA; ACADEMIC medical centers; STATISTICAL correlation; CYTOCHEMISTRY; HYSTEROSCOPY; LONGITUDINAL method; EVALUATION of medical care; DILATATION &; curettage; DIAGNOSIS
- Publication
Journal of Gynecologic Surgery, 2017, Vol 33, Issue 6, p226
- ISSN
1042-4067
- Publication type
Article
- DOI
10.1089/gyn.2017.0028