Endometrial congestion is the only hysteroscopic finding indicative of chronic endometritis
Mayuko Furui1,2,3, Ayumu Ito1,2,3, Yusuke Fukuda1,2,3
1Faculty of Medicine, Department of Obstetrics and Gynecology, Toho University, Omori-nishi, Ota-ku, Tokyo, Japan.
Insights
Chronic endometritis (CE), a uterine inflammation linked to infertility, may be diagnosed using hysteroscopy. Endometrial congestion observed during hysteroscopy showed moderate agreement with biopsy results, suggesting its potential as a predictive marker for CE.
Area of Science:
- Reproductive Medicine
- Gynecologic Pathology
- Diagnostic Imaging
Background:
- Chronic endometritis (CE) is an inflammatory uterine condition associated with infertility and recurrent miscarriages.
- Traditional diagnosis relies on endometrial biopsy with CD138 staining.
- Hysteroscopy's role in diagnosing CE remains debated.
Purpose of the Study:
- To evaluate the diagnostic accuracy of hysteroscopy for chronic endometritis.
- To compare hysteroscopic findings with biopsy-confirmed CE diagnoses.
- To identify specific hysteroscopic features indicative of CE.
Main Methods:
- Retrospective observational study at Toho University Omori Medical Center (June 2017 - November 2019).
- Included patients underwent both hysteroscopy and endometrial biopsy.
- Analyzed hysteroscopic features: congestion, micropolyps, edema, and polyps.
Main Results:
- Endometrial congestion was the sole hysteroscopic finding significantly associated with CE.
- A moderate diagnostic agreement was observed between hysteroscopy and biopsy for CE.
- Micropolyp, edema, and polyp findings were not significantly linked to CE.
Conclusions:
- Endometrial congestion identified during hysteroscopy may serve as a potential predictive marker for chronic endometritis.
- Further research is needed to explore hysteroscopic features for CE diagnosis.
- Hysteroscopy, particularly noting endometrial congestion, could aid in evaluating women with suspected CE.
Abstract:
Chronic endometritis (CE), an inflammatory condition characterized by plasma cell infiltration within the endometrial stroma, is prevalent among women experiencing unexplained infertility or recurrent miscarriages. CE is traditionally diagnosed by endometrial biopsy using CD138 immunohistochemistry staining. Despite some studies suggesting hysteroscopy as an alternative diagnostic tool, its reliability compared with biopsy remains controversial. This study evaluated the diagnostic accuracy of hysteroscopy for CE by examining endometrial features, such as congestion, micropolyps, edema, and polyps, and comparing these with biopsy-confirmed cases of CE. This retrospective observational study was conducted at Toho University Omori Medical Center between June 2017 and November 2019 and included patients undergoing both hysteroscopy and histopathological examination. Endometrial congestion was identified as the only hysteroscopic finding significantly associated with CE, showing a moderate diagnostic agreement with biopsy results. These findings highlight the importance of further investigating hysteroscopic features of CE and their diagnostic implications and identify endometrial congestion as a potential predictive marker for CE.
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