Reliability of out-patient hysteroscopy in one-stop clinic for abnormal uterine bleeding

Abstract

This study aims to estimate the effect of adding office hysteroscopy to the preoperative diagnostic work-up in abnormal uterine bleeding on the diagnostic accuracy. It is a prospective comparative diagnostic trial at a tertiary care referral facility and a university hospital. There were a total of 295 patients, more than 35 years old, with abnormal uterine bleeding. The patients had vaginal sonography, office hysteroscopy, and office endometrial biopsy on onestop bases. The diagnostic accuracy of each method in diagnosing focal lesion and endometrial hyperplasia was measured as the main outcome of this paper. Combined hysteroscopy and biopsy were taken as the gold standard for diagnosing focal lesion while endometrial biopsy alone was the gold standard for diagnosing endometrial hyperplasia. Office hysteroscopy was superior to other methods for diagnosing focal lesion with about half of the focal lesions failing to be diagnosed with the other two methods. Office hysteroscopy was superior to vaginal sonography in diagnosing endometrial hyperplasia. Office hysteroscopy is an indispensable tool for diagnosing abnormal uterine bleeding and without its use, half of the focal lesions could be missed. Office setting and the one-stop approach greatly facilitate the use of the combination of office hysteroscopy with vaginal sonography and office endometrial sample.

Routine vaginoscopic office hysteroscopy in modern infertility work-up: a randomized controlled trial

“…Detection of delicate endometrial lesions is a marvelous advantage of OH over other diagnostic tools. In a previous study, this team could diagnose endometrial lesions that could not be seen by other tools [2]. In about two third of infertility cases, hysteroscopy findings were not correlated with those found on HSG [9].…”

“…Office hysteroscopy is an exciting modern diagnostic tool with expanding popularity all over the world [2]. Adding vaginoscopic approach to office hysteroscopy is an extra simplification of the procedure with elimination of pain during examination [3].…”

Endoscopic Explanation of Unexplained Infertility

“…Some invitro 3D studies were recently published but did not fully explain these complicated tubal phenomina [25]. Office hysteroscopy (OH) is a modern diagnostic tool with expanding popularity all over the world [26]. Adding vaginoscopic approach to office hysteroscopy is an extra simplification of the procedure with elimination of pain during examination [27].…”

Hysteroscopic evaluation of endometrial changes and fallopian tubal functions in women using progestin-only contraceptives

“…[2][3][4][5][6][7] There is a need for a better understanding of the mechanisms of AUB in women using POCs, 8 and thus for individualized treatment rather than the current empirical lines of therapy. 9 Office hysteroscopy (OH) has long been used to examine the uterine cavity in many gynecological conditions such as AUB, 10 unexplained infertility, and recurrent pregnancy loss. 11,12 In recent years, we have extensively studied the proximal part of the FT using a bubble flow test and physiological peristalsis via OH.…”