Five Years’ Experience on Hysteroscopy in Abnormal Vaginal Bleeding (original) (raw)
Related papers
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 Diagnosis of Hysterectomy Specimens in Abnormal Uterine Bleeding
Pakistan Journal of Medical and Health Sciences, 2023
Background: Abnormal uterine bleeding (AUB) is a common and distressing condition effecting predominantly perimenopausal women. Heavy menstrual bleeding (HMB) is the most common presentation of AUB. There are many structural and non structural causes of AUB. Histopathology of endometrial curettings is well studies before but the histopathological patterns of hysterectomy specimens are not well studied. Objective: The objective of this study is to: Find out histopathological diagnosis of hysterectomy specimens in patients of AUB. Study Design: Retrospective Cohort study. Place and Duration of Study: Gynecology and Pathology departments of Azra Naheed and Rashid Latif medical colleges from January 2022 to January 2023. Methods: Histopathology reports of all hysterectomies done for AUB in both medical colleges allied hospitals were retrieved retrospectively and evaluated in detail. Four age groups were defined 30-40 years, 41-50, 51-60 and 61-70 years. Various patterns were recorded overall and separately for each group and results established. Results: A total of 221 abdominal hysterectomy histopathology reports were retrieved and evaluated. All hysterectomies were performed for AUB during one year period between January 2022 to January 2023. 40(18.09%) women were between 30-40 years of age, 134(60.6%) were between 41-50 years of age, 39(17.6%) were between 51-60 years of age and 08(3.61%) patients were between 61-70 years of age. Distorted proliferative phase endometrium was seen in 28(12.6%) of cases, Adenomyosis was seen in 76(34.38%), endometrial polyps in 19(8.55%), fibroids in 92(41.6%), metaplasia 07(3.1%), hyperplasia 10(4.5%), and endometrial carcinoma was seen 09 (4.07%) of cases. Conclusion: AUB is most common in perimenopausal women. Fibroids, Adenomyosis, and disordered proliferative endometrium were most common in perimenopausal women while carcinoma endometrium was most common cause of AUB in postmenopausal women. This study will help Gynecologists to better find out the cause of AUB and treat accordingly.
Role of hysteroscopy in abnormal uterine bleeding and its histopathological correlation
International Journal of Clinical Obstetrics and Gynaecology
Background: Abnormal uterine bleeding (AUB) is the regularly experienced gynecological issue. The goal was to survey the accuracy of demonstrative hysteroscopy in assessment of abnormal uterine bleeding and to correspond hysteroscopic discoveries with histopathology reports. Materials and Methods: One hundred and twenty cases were chosen for this investigation from patients of age 20-60 years, who were conceded with the historical backdrop of abnormal uterine bleeding. Hysteroscopic examination was done in all patients post-menstrually, at whatever point conceivable, aside from in those situations where menstrual cycles were irregular or patients accompanied nonstop bleeding per vaginum. The patients at that point experienced dilatation and curettage. The endometrium was sent for histopathological examination. The connection between discoveries on hysteroscopy and histopathological examination was organized. Result: AUB was more common in patients of age 32-40 yrs. The most widely recognized complaint was Menorrhagia. On hysteroscopy 55% of patients had some anomaly which incorporates: endometrial hyperplasia, polyps, submucous myoma, endometrial atrophy, endometrial carcinoma, misplaced IUCD, and synechiae comprising and tubercular endometritis. Hyperplasia was the most widely recognized discovery which was seen in 24% patients. Both hysteroscopy and curettage were precise when a variation from the norm was analyzed, yet the capacity to determine a lesion was more with hysteroscopy in contrast with curettage. Hysteroscopy uncovered more data than curettage. Conclusion: Hysteroscopy is an eye in uterus and it gives more exact conclusion than dilatation and curettage alone in patients with anomalous uterine bleeding.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2014
Background: The objective was to assess the accuracy of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and to correlate hysteroscopic findings with histopathology reports. Methods: A prospective study was carried out at our institute from January 2010 to December 2013. Ninety cases were included in this study. Patients" age varied from 20 to 60. Those women with the history of abnormal uterine bleeding were admitted. In all cases diagnostic hysteroscopic examination and dilatation and curettage were carried out. Endometrium was sent for histopathology and correlation of hysteroscopic findings with histopathology reports was studied. Results: Various findings on hysteroscopy are as following: proliferative endometrium 36.66%, secretary endometrium 17.77% endometrial hyperplasia 24.44%, atrophic endometrium 5.55%, endometrial polyp 8.88%, submucous fibroid 4.44%, and endometrial carcinoma 2.22%. Conclusions: Hysteroscopy is an eye in uterus and it provides more accurate diagnosis than dilatation and curettage alone in patients with abnormal uterine bleeding.
Hysteroscopy in evaluation of intrauterine causes of abnormal uterine bleeding
International Journal of Research in Medical Sciences, 2020
Background: Various endometrial pathologies contribute to a large proportion of cases of abnormal uterine bleeding (AUB) during the reproductive years as well as after menopause. Methods: This is a retrospective observational study conducted in department of Obstetrics and Gynaecology at SMGS Hospital, Jammu. 200 patients between 20-70 years age presenting to gynaecology OPD with abnormal uterine bleeding between January 2019 to December 2019 were studied. All patients were subjected to thorough clinical evaluation followed by hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB were studied. Hysteroscopy directed biopsies were taken in the same sitting and sent for histopathology and culture. Results: Mean age of patients in our study was 45 years with majority of patients in 40-50-year age group (69%). Most common symptom reported was menorrhagia (48%) followed by menometrorrhagia (18%) and polymenorrhea (10%). Hysteroscopy detected in...
The Prevalence of Significant Pathology in Women Presenting With Abnormal Uterine Bleeding
2016
Aims: To detect the Prevalence of Endometrial Carcinoma in women presenting with Abnormal Uterine Bleeding in Peri-menopausal Age and to reduce the iatrogenic hysterectomy done for benign endometrial pathology. Study design: A Cross-sectional Study. Setting: The study was conducted in OB/GYN Unit II Sir Ganga Ram Hospital Fatima Jinnah Medical University, Lahore from 1st January 2014 to 31st December 2015; one year study. Methods: 132 cases of hysterectomy specimens were analyzed alter Total Abdominal Hysterectomy +/Bilateral Salpingo-ophorectomy..The specimens were routinely processed and stained with hemotoxylin and eosin slides were studied under Electron Microscope by the Histopathology Department of Fatima Jinnah Medical University. Results: The Mean age of patients was 47.5 years (SD+/-4) 132 patients (74%) of cases were from peri-menupausal age group. The most common presenting complaint was menorrhagia 71 patients (56.06%) followed by irregular bleeding in 16 patients (12.12...