Role of hysteroscopy in the evaluation of abnormal uterine bleeding

Dr Ajay Chhikara; Dr Archana Bharti

Volume : VI, Issue : VI, June - 2016

Role of hysteroscopy in the evaluation of abnormal uterine bleeding

Dr Ajay Chhikara, Dr Archana Bharti

Abstract :

 Introduction: Abnormal uterine bleeding(AUB) accounts for 30–40% of all gynaecological cases. Hysteroscopy allows direct visualisation of structural lesions within the endometrial cavity and can be performed as a diagnostic and therapeutic procedure in the same sitting. Objective: To assess the accuracy of the hysteroscopic diagnosis with that of hystopathological reports obtained by endometrial sampling. Materials and Methods: A prospective cross–sectional study in which hysteroscopy was performed for 50 patients with AUB. Hysteroscopy was done and after noting the findings, hysteroscope was withdrawn out of uterine cavity. Endometrial sampling was done. Then hysteroscope was reinserted and biopsy of persisting focal lesion was taken. Both samples were sent for histopathology. Result of hysteroscopy and endometrial sampling were compared. Statistical analysis was done by calculating sensitivity and specificity of hysteroscopy versus histopathology by targeted hysteroscopic biopsy and endometrial sampling. Results: The mean age of the study group was 40.35±5.4 years(range 26–60 years). The mean parity was 3.2±1.5. The most common symptom was menorrhagia (40%) followed by metrorrhagia 38%, polymenorrhagia(12%) and postmenopausal bleeding(10%). The overall sensitivity and specificity of hysteroscopy for diagnosing intrauterine abnormalities was 84% and 72% respectively. Sensitivity and specificity of the procedure for endometrial hyperplasia was 66.6 and 90.2% respectively. For endometrial polyps, the results were 80% and 97.5% respectively. The sensitivity and specificity of the procedure was 100% for submucous fioids and 100% and 95% respectively for inflammation. The sensitivity and specificity for atrophic endometrium was 100% and 95.9% respectively. Conclusion: Hysteroscopy is a valuable tool for diagnosing endometrial inflammation, atrophic endometrium and focal lesions like endometrial polyps and submucosal fioids. However hysteroscopy is not very reliable diagnostic modality for endometrial hyperplasia.