Five Years’ Experience on Hysteroscopy in Abnormal Vaginal Bleeding (original) (raw)
Fertility and Sterility, 2008
To describe the prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding (AUB).Retrospective series of consecutive patients.Tertiary care university hospital and private office.Four thousand fifty-four hysteroscopies with biopsy in patients with AUB evaluated between June 1993 and December 2004.Hysteroscopies were performed using 2.9-mm or 4-mm telescopes with CO2 or saline as the distension media. Biopsies were done with a 5-mm grasper or with a Novak's curette.Prevalence of hysteroscopic findings and histologic analysis of biopsies.Endometrial polyp was the most frequent hysteroscopic finding, accounting for 1,374 (33.9%) cases. Normal uterine cavity and cervical canal were found in 814 (20.1%) patients. Submucous fibroids were diagnosed in 302 (7.5%) women. Normal endometrium was the most frequent histologic diagnosis, accounting for 1,888 (46.6%) cases. Endometrial polyp was found in 1,115 (27.5%) patients. Endometrial hyperplasia was diagnosed in 613 (15.1%) and endometrial cancer in 105 (2.6%) women.Endometrial polyps are the most frequent hysteroscopic findings in patients with AUB, whereas normal endometrium is the most frequent histologic diagnosis.
Bleeding and Hysteroscopy in Uterine Myomatosis
Fibroids
Uterine leiomyomas are one of the most common diseases in women. However, there is still much about them we do not know. These tumours, also known as fibroids or myomas, affect women mainly during their reproductive years, and they are diagnosed in up to 70% to 80% of women during their lives. The most relevant part of this disease is the profound impact in the quality of life of women, in the provision of health services, and on the costs all around the world. Even though, the majority of women with fibroids are asymptomatic, approximately 30% of them will present severe symptoms, with a broad range of problems such as: abnormal uterine bleeding, infertility, and obstetric complications. There are multiple factors involved in the biology of fibroids: genetic, epigenetic, hormonal, proinflammatory, angiogenic and growth factors, growth factors that are capable of inducing and promoting de development of fibroids. The leiomyoma is surrounded by a pseudocapsule generated by compressio...
Role of Hysteroscopic EvaluationinAbnormal Uterine Bleeding and its histopathological co-relation
The present study was conducted to assess the feasibility and accuracy of hysteroscopy in evaluation of intrauterine abnormalities in women with abnormal uterine bleeding and to correlate it with histopathological evaluation.50 women in the reproductive, perimenopausal and postmenopausal age group, up to the age of 65 years presenting with AUB were included as per the inclusion and exclusion criteria. All patients underwent a hysteroscopic examination followed by a biopsy and histopathological evaluation. Hysteroscopic findings were noted and compared with histopathological findings.sensitivity, specificity, PPV, NPV and accuracy of hysteroscopy was calculated. Results: Maximum age incidence was between 41-50 years (46%).Of the 100 patients, maximum number of women (66%) had symptoms for less than 6 months, 13 patients (26%) had symptoms for 6 months to 1 year and 4 patients (8%) had symptoms for more than 1 year.Out of total 50 patients, 42% presented with Menorrhagia. The second commonest presentation was metrorrhagia (32%). There were 7 cases (14%) with Polymenorrhea and 14 (28%) patients with post-menopausal bleeding and 6% had intermenstrual spotting.Of the 50 patients, 46 cases (924%) were Multiparous, and 4 cases (8%) were Nulliparous. Abnormal findings were seen in 35 patients (70%), while in the remaining 15 patients (29%), no abnormality was detected (negative hysteroscopic view). The most common abnormality was endometrial Hyperplasia (20%cases), followed by Endometrial Polyps (18%) and submucosal fibroids (16%).There were also 7 cases (14%) of endometrial atrophy and 1 case of endometrial carcinoma. Of the 50 cases, 23 (46%) were normal on histopathology. The most common abnormality observed was polyp (20% cases), followed by submucosal fibroids (16%), endometrial Hyperplasia (14%) and endometrial carcinoma (4%).The sensitivity, specificity, PPV and NPV of Hysteroscopy to diagnose polyp was 90%, 100%, 100% and 97.6% respectively. All the case of fibroids were correctly diagnosed by hysteroscopy, thus sensitivity, specificity, PPV and NPV of Hysteroscopy were all 100%. The sensitivity, specificity, PPV and NPV of Hysteroscopy to diagnose endometrial hyperplasia was 85.7%, 90.7%, 60% and 97.5% respectively. The sensitivity, specificity, PPV and NPV of Hysteroscopy to diagnose endometrial carcinoma was 50%, 100%, 100 and 98% respectively.
Use of Hysteroscopy in Abnormal Uterine Bleeding: An Edge Over Histopathological Examination
Journal of obstetrics and gynaecology of India, 2018
To assess the efficacy of hysteroscopy in diagnosis of AUB. A total of 56 women in reproductive and peri-menopausal age group (20-50 years) with complaints of abnormal uterine bleeding were enrolled in the study. All the patients underwent hysteroscopic examination followed by biopsy/histopathological evaluation. Hysteroscopic findings were compared against histopathological findings. Sensitivity, specificity, PPV, NPV and accuracy of hysteroscopy were calculated. Mean age of patients was 36.4 ± 7.6. Majority (60.7%) presented within 6 months of complaints. Clinically, 66.1% were diagnosed as menorrhagia, 30.4% polymenorrhoea and 3.6% intermenstrual bleeding. Hysteroscopically 53.6% presented with abnormal pathology, it diagnosed polyps in 16.1%, calcification in 12.5%, submucous fibroma in 10.7%, necrotic mass in 7.1%, adhesion and forgotten IUCD in 5.4% cases each. However, on histopathology, 33 (58.9%) cases had normal/proliferative/atrophic endometrium, 12 (21.4%) had hyperplasi...
Hysteroscopy in Evaluation of Abnormal Uterine Bleeding
The Journal of Obstetrics and Gynecology of India, 2011
One-third of all gynaecological consultations are because of abnormal uterine bleeding (AUB). This proportion rises to more than 2/3rd when peri & post menopausal women are considered. In normal to 12 week size uteri, the cause of abnormal bleeding often remains obscure. Objectives (S) Clinical and hysteroscopic evaluation of the cervical canal & uterine cavity of 100 women with AUB to evaluate various causes of AUB in the study population. Method (S) 100 women with AUB and uterine size normal to 12 weeks pregnancy were subjected to clinical & hysteroscopic examination. The cause of bleeding was evaluated. Results Menorrhagia (30%), menometrorrhagia (16%), oligomenorrhea (16%) and postmenopausal bleeding (2%) were some of the indications for hysteroscopy. Intrauterine pathology was diagnosed in 74% of cases. Hyperplastic endometrium (30%) and mucus polypi (28%) were the most frequent findings. 13% of the cases had multiple finding. A surprising 7% had IUCD in their uteri without their knowledge, while bony spicules was found in 1 patient. Both patients with post menopausal bleeding had atrophic endometrium. Conclusion (S) Hysteroscopy can be easily learnt. It gives a clue to diagnosis in AUB and can reduce the burden of hysterectomy in many cases which can be treated by simple procedures.
Histopathological findings of endometrial specimens in abnormal uterine bleeding
Archives of Gynecology and Obstetrics, 2013
The aim of this study was to assess the frequency of different histopathological findings obtained from dilatation and curettage (D&C) specimens in patients with abnormal uterine bleeding (AUB). Methods In a retrospective review of 591 specimens, the included subjects were all women with AUB who underwent D&C between 2002 and 2006 in Be'sat Hospital, Tehran, Iran. The pathological diagnoses were analyzed in four groups from normal to malignant endometrium. The pathological groups were evaluated for patients' characteristics including demographic data and medical history. Results The majority of patients (61.6 %) were in the 41-50 year age group. Totally, 81.4 % of patients had normal pathology. The disordered proliferative endometrium/polyps, hyperplasia, and malignant pathology were found in 15.4, 2.5, and 0.7 % of specimens, respectively. The abnormal pathologies were seen more among patients with postmenopausal status, nulli-/primigravid women, and those with hypertension, diabetes, hypothyroidism, and polycystic ovary syndrome. Conclusions The proliferative endometrium and secretory endometrium were the most common histopathological observations in AUB patients in our region, and except normal endometrium, disordered proliferative endometrium was the most common cause of AUB.
A Study of Uterine Pathology in Patients Presenting With Abnormal Uterine Bleeding
IOSR Journal of Dental and Medical Sciences, 2017
Backgroud: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in Gynaecology outpatient department. Endometrial sampling could be effectively used as the first diagnostic intervention in AUB, although at times, its interpretation could be quite challenging to the practicing pathologists. This study was done with hysterectomy specimen to evaluate histopathology for identifying the various etiologies in the age group between 45-60yrs presenting with AUB. Objective: To determine the histopathologic spectrum of lesions associated with AUB in age group between 45-60yrs. Material and Methods: This retrospective study was done at Government kilpauk Medical College,Chennai, India with hysterectomy specimen of 165 patients who presented with AUB from Jan2015-July 2016. Data including age and clinical indication for hysterectomy was collected for the study. The specimens were processed routinely and stained with hematoxylin and eosin stain and examined microscopically
Study of etiopathogenesis and clinical profile of patients presenting with abnormal uterine bleeding
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Abnormal uterine bleeding (AUB) may be defined as any variation from the normal menstrual cycle, including alteration in regularity, frequency of menses, duration of flow and amount of blood loss. 1 It is the most common presenting symptom and major gynecological problem affecting as many as one-third of all out patient gynecologic visit. 2,3 AUB can occur at any age in various forms with different modes of presentation. Abnormal uterine bleeding during the reproductive age can result from a broad spectrum of conditions ranging from physiological process to malignant lesions involving organic, systemic and hormonal responses. The International Federation of Gynecology and Obstetrics working group on menstrual disorders has developed a classification system PALM-COIEN for causes of AUB in non-pregnant women of reproductive age. 4 The classification system is divided into nine categories that are arranged according to the acronym PALM-COEIN: polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory disorders, endometrial, iatrogenic and not classified. Out of all the etiologies, age variation and clinical ABSTRACT Background: AUB is a common condition affecting 14-25% of women of reproductive age and may have a significant impact on their physical, social, emotional and material quality of life. AUB can occur at any age in various forms and has different modes of presentation. The key to successful clinical management is to recognize or identify the causative factors responsible. Methods: This study was conducted over 100 patients. Patients with complaints of menstrual irregularity between menarche to premenopausal age group were considered. Data about age, parity, menstrual history, obstetric history, medical history, physical examination, thyroid function test, radiological findings and histopathology were collected and studied. Results: Incidence of AUB is more common in 5th decade of life. Menorrhagia is the most common bleeding pattern. It is concluded that DUB is the most common cause of AUB. Among the other organic pathological causes, fibroid is the commonest. Maximum number of apparently normal patients with abnormal uterine bleeding belong to category of sub clinical hypothyroid. Conclusions: Accurate analysis of endometrial sample is the key to effective therapy and rational approach to treatment of women with abnormal uterine bleeding.
Journal of Evidence Based Medicine and Healthcare, 2019
BACKGROUND Abnormal uterine bleeding (AUB) is a common problem mainly seen in peri-menopausal and post-menopausal women. AUB has a negative impact on quality of life and in turn affects the efficiency of women. Hysteroscopy in this new era is increasingly becoming the investigation of choice for the evaluation of AUB, owing to the direct visualization of the uterine cavity, and its ability to pinpoint the aetiology in most of the cases.