Use of Hysteroscopy in abnormal uterine bleeding: An edge over histopathological examination & blind D & C: an ambulatory procedure

Abstract

AUB is the most common complain of reproductive age group women. In this study the causes & findings of AUB were compared by performing hysteroscopy & D & C and their histopathology also compared thoroughly . Materials & Methods: This study was a prospective study carried out in SCB medical college, a tertiary care hospital in Odisha, from Aug 2013 to Aug 2015 for 2 years. 200 cases were selected for this study aging 18 years and above with menstrual irregularities. Hysteroscopy was performed in 100 patients, endometrial biopsy was taken during the procedure & sent for HP study. In another 100 patients, D & C was performed & sent for HP study as control basis. The findings on hysteroscopy and D & C and there HP reports were correlated and compared. Results: On hysteroscopy , out of 100 cases , 32 % came as proliferative , 16 % secretory ,16 cases as sub mucous fibroid , 13 cases as endometrial hyperplasia ,8 cases as endometrial atrophy, 4 cases as endometrial adhesion ,1 case as CuT in situ & 1 case of endometrial carcinoma whereas HP study on same patients came as 43 % as proliferative, 20 % as secretary, 18 % as hyperplasia, 6% as endometrial polyp,4% as atrophic endometritis, 2 % as fibroid polyp, 1% absent endometrium & 1% as endometrial carcinoma . Another 100 patients on whom blind D & C were performed came as 52 % as proliferative, 20 % secretory, 19% as endometrial hyperplasia, 6% as atrophic endometrium and 3 % as endocervical polyp. Conclusion: In patients with AUB, hysteroscopy provides more accurate and detailed diagnosis than dilatation and curettage alone. Especially endometrial cavity lesions are more accurately diagnosed by hysteroscopy and also in similar setting; therapeutic procedures can be performed than the blind D & C procedure.

Evaluation of intrauterine pathologies by hysteroscopy in abnormal uterine bleeding

“…[21][22][23][24][25][26] As has been suggested the use of blind endometrial sampling to evaluate the uterine cavity, is an inaccurate technique for diagnosing pathologies commonly associated with AUB, such as endometrial polyps, submucous myomas, and focal endometrial abnormalities including adenocarcinoma and its precursors. 16 The use of hysteroscopy with directed biopsy ensures the recognition of these lesions. Furthermore, assigning a specific pattern to a diagnosis will help triage the patterns which will need to be sampled from those which can be left alone decreasing the burden on the pathologist and the unnecessary anxiety for the patient waiting for the biopsy report.…”

“…In fact, it is an eye in the uterus. 16,17 This study was done to evaluate the role of hysteroscopy in diagnosing intrauterine causes of AUB.…”