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Abnormal uterine bleeding. Diagnostic value of hysteroscopy
1Salmaniya Medical Complex, Manama, State of Bahrain.
Saudi Medical Journal
|April 12, 2001
Summary
Hysteroscopy shows high specificity for endometrial cancer but lower sensitivity. For abnormal uterine bleeding, hysteroscopy combined with curettage is recommended, with office hysteroscopy as a potential alternative to hospital procedures.
Area of Science:
- Gynecological diagnostics
- Endometrial evaluation
- Minimally invasive procedures
Background:
- Abnormal uterine bleeding (AUB) necessitates accurate diagnosis.
- Hysteroscopy and dilatation and curettage (D&C) are common diagnostic tools for AUB.
- Comparing the diagnostic accuracy of hysteroscopy versus histology is crucial.
Purpose of the Study:
- To compare hysteroscopic impression with histological diagnosis for AUB evaluation.
- To assess the diagnostic value of hysteroscopy and histology.
- To determine if office hysteroscopy can replace hospital D&C for AUB.
Main Methods:
- Retrospective study of 556 patients with AUB.
- Patients underwent both hysteroscopy and D&C.
- Comparison of hysteroscopic findings with histological results.
Main Results:
- Hysteroscopy detected polyps and submucous leiomyomas more often than histology.
- Histology confirmed only 24.5% of hysteroscopically diagnosed polyps.
- Hysteroscopy demonstrated high specificity (85-99.5%) but low sensitivity (30-40%) for hyperplasia and carcinoma.
Conclusions:
- Hysteroscopy is more sensitive for polyps/fibroids, less sensitive for hyperplasia/carcinoma compared to curettage.
- Combined hysteroscopy and curettage are recommended for AUB evaluation.
- Office hysteroscopy with biopsies may reduce the need for hospital D&C.