[Diagnostic possibilities of the flexible hysteroscopy in irregular uterine bleeding]

The aim of the present study was to evaluate the possibilities of diagnostic flexible hysteroscopy for women with irregular uterine bleeding. The study was based on 569 women aged between 26 and 72 years (mean age 46.78 years) with weak to moderate irregular uterine bleeding who had given agreement for invasive investigations. To all patients initially was performed diagnostic hysteroscopy with the help of a panoramic fibrohysteroscope Pentax LH-150 II (with 5 mm diameter), followed by classical endometrial curettage. The performed hysteroscopies found phase or other normal endometrium at 208 women (36.56%), hyperplasia and poliposis at 258 (45.34%), changes, suspected for atypia and neoplasia at 77 (13.53%) and other different findings at 26 women (4.57%). The following curettage showed the lack of adequate material from uterine cavity at 24 women (4.2%). From the rest patients, at 466 (81.9%) the morphological findings were due to the dysfunctional reasons, other 51 (8.9%) were with different precancer and cancer lesions and at 28 cases, clinically and morphologically was found that the bleeding was due to the presence of sub mucous nodules, intrauterine devices, residua and pathology of the chorion. The comparison of the hysteroscopy results with the clinical and histological findings from the curettage of 454 women, showed good diagnostic possibilities (sensitivity of 78.4% and specificity of 92.5%) of the flexible hysteroscopy for evaluation of women with irregular uterine bleeding. This examination is relatively simple and save endoscopic technique, which require simultaneously performance of a direct biopsy, in order to improve its diagnostic accuracy.