Diagnostic value of endometrial curettage in abnormal uterine bleeding--a histopathological study

Endometrial curettings from 458 patients presenting with abnormal uterine bleeding were studied. This included 220 (48%) patients with metrorrhagia, 187 (41%) with menorrhagia, 30 (6%) with postmenopausal bleeding, 13 (3%) with intermenstrual bleeding and 8 (1.74%) with polymenorrhagia. The histological findings were correlated with the pattern of abnormal bleeding in five different age groups. In 48.5% of the biopsies, histology assisted in diagnosing the cause of bleeding viz, intrauterine lesion in 25.5% and an ovulatory cycles in 22.9%. The endometrial lesions detected on histopathology included 2 (0.44%) endometrial adenocarcinomas, one (0.21%) carcinosarcoma, one (0.21%) metastatic mucinous adenocarcinoma, 41 (8.95%) benign polyps, 51 (11.1%) endometrial hyperplasia, 15 (3.28%) endometritis and 6 (1.3%) atrophic endometrium. The curettage was found to be of relatively low diagnostic value in menorrhagia and intermenstrual bleeding while its diagnostic yield was high in patients with postmenopausal bleeding and metrorrhagia.