Role of Hysteroscopy in Diagnostic Evaluation of Intrauterine Causes of Abnormal Uterine Bleeding Compared to Pathology Reports .
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 9
Abstract
Background: Abnormal uterine bleeding is a common gynaecological problem affecting 25-35% women of reproductive age group and upto 50 % women of perimenopausal age group .there are various causes of AUB classified according to PALM COEIN classification .it is a debilitating condition affecting women in their middle age and its management depends on correct diagnosis. hysteroscopy is an important diagnostic modality used for diagnosis of structural causes of AUB . AIM of study: To study role of hysteroscopy in diagnostic evaluation of intrauterine causes of AUB compared to histopathology reports . Material and methods: This is a retrospective observational study in which we studied 350 patients of AUB who underwent hysteroscopy for diagnostic evaluation followed by guided biopsy of the lesions and D& C . hysteroscopic findings and histopathology reports were reviewed for all patients and correlated . Observation and results: 80 % patients were in peri and postmenopausal age group in our study .Commomest presenting symptom was menorrhagia .Hysteroscopy detected abnormality in 210 cases of AUB. Most common pathology seen on hysteroscopy was polyp followed by hyperplastic thickened endometrium. Sensitivity of hysteroscopy for detecting intrauterine pathology was 100 % and specificity was 76.5% .PPV and NPV value were 79.5% and 100% respectively . hysteroscopy detected all cases of polyp and submucous myomas .it overdiagnosed few cases of hyperplastic endometrium but did not miss any case of hyperplasia or malignancy . Conclusion: diagnostic hysteroscopy is good for evaluation of intrauterine causes of AUB and it correlates well with the hitopathology reports especially for the detection of polyps , submucous myomas and endometrial hyperplasia . hence it can be used as a first line diagnostic test for detection of these abnormalities and taking guided biopsy from any lesion ,however it can not replace biopsy and histopathological evaluation which gives a detail understanding about the nature of the pathology like hyperplastic endometrium and rulesout atypia and malignancy .hence hysteroscopy with guided biopsy should be ideal for diagnostic evaluation of intrauterine causes of AUB .
Authors and Affiliations
Naik Meena, Ratnani Rekha
Keywords
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