The role of office hysteroscopy in the diagnosis of endometrial hyperplasia: A cross sectional study from central India.

Prasanta K Nayak; Subarna Mitra; Amit Bugalia; Sarita Agrawal; Neha Sinha; Pavan B C; Vinita Singh

Volume : IX, Issue : VI, June - 2020

The role of office hysteroscopy in the diagnosis of endometrial hyperplasia: A cross sectional study from central India.

Prasanta K Nayak, Subarna Mitra, Amit Bugalia, Sarita Agrawal, Neha Sinha, Pavan B C, Vinita Singh

Abstract :

Introduction: The role of office hysteroscopy in the evaluation of endometrium in cases with abnormal uterine bleeding (AUB) has advantage of being a day care procedure without need for anaesthesia. Ultrasonographic evaluation of endometrial thickness is essential in evaluation of AUB. Hence, the combination of ultrasound and modern office hysteroscopy can be used in comprehensive assessment of endometrial pathology. Office hysteroscopy can be a preferred tool for clinicians which can not only diagnose but also treat menstrual disorders in a one–stop clinic. Materials and methods: This cross sectional study was undertaken in a tertiary care centre in central India from Feuary 2016 to October 2017 after institute ethical committee approval. In this study 124 women with AUB were evaluated after informed consent. Pre–operative ultrasonography was performed to record the endometrial thickness followed by office hysteroscopy. Endometrial tissue was sent for histopathological study. Results: Majority of the patients i.e 60 (48.38%) had secretory endometrium. We got 2 cases of endometrial cancer, 21 cases with simple hyperplasia without atypia and 3 cases with simple hyperplasia with atypia. Office hysteroscopy had a sensitivity of 92.3%, specificity of 66.3%, positive predictive value (PPV) of 42.11%, negative predictive value (NPV) of 97.01% and diagnostic accuracy of 71.77% in diagnosing endometrial hyperplasia. The best cut off of the endometrial thickness for the prediction of endometrial hyperplasia was found to be 10.88 mm. Conclusion: Office hysteroscopy has a very high sensitivity and negative predictive value in diagnosing endometrial hyperplasia.