Hysteroscopic assessment of patients with abnormal uterine bleeding: a prospective study at a tertiary care hospital

Abstract

INTRODUCTIONUterine bleeding is a normal physiologic episodic occurrence for most women. Its characteristics vary considerably. The broad range of normal variation causes difficulty in identifying abnormal patterns. The problem is that the uterine bleeding has a wide range of diagnostic possibilities and confusion is generated when review and reports fail to outline the diagnostic evaluation of patient who presents with abnormal uterine bleeding patterns. 1,2Dilatation and Curettage is a blind procedure and the endometrium has to be sent to the pathologist to study histological patterns. The co-operation of the pathologist is important. Ultrasonography clearly depicts the contour and the status of the ovary, but fails to provide adequate information regarding the endometrium. 3Hysteroscopy has ushered a new era in the evaluation of abnormal uterine bleeding. By direct visualization of the uterine cavity it is able to pin point the etiology in majority of the cases. It can detect endometrial hyperplasia accurately and aids in the early diagnosis of endometrial carcinoma and uterine polyps. 4 Abnormal uterine bleeding is one of the most common complaints with which a patient presents to a Gynecologist. Dilatation and Curettage has long been the diagnostic gold standard for abnormal uterine bleeding. However, only 70-80% of the endometrium can be curetted. Polyps and sub mucous fibroids are frequently undetected by curettage alone.1 The judicious use of hysteroscopy to manage this medical entity adds a new dimension in handling this often perplexing problem. Conclusions: Hysteroscopy is highly sensitive diagnostic procedure which not only provides useful information of the uterine cavity but also an ideal method for the evaluation of patients with abnormal uterine bleeding.