Hysteroscopy as a diagnostic tool in case of abnormal uterine bleeding.

Abstract

Background
Abnormal Uterine Bleeding is most commonly encountered in peri-menopausal and post-menopausal women. Abnormal uterine bleeding has a negative impact on quality of life and in turn affects the efficiency of the women. As other diagnostic tools Hysteroscopy can also be used as an office procedure.
Material & method
The present retrospective study analysis was conducted on 86 women attending the Gynaecology OPD at Hi-tech Medical college, Bhubaneswar, Odisha. from March 2021 to February 2023. Women attending OPD in the reproductive age group ie (20-40 years) and peri-menopausal age group ie more than 40yrs, with complaints of abnormal uterine bleeding were included. After obtaining postcounseling written informed consent, Thorough physical examination and routine pre-op blood investigations (Hemoglobin, ABO & Rh, Blood sugar, urine REME) done, which was followed by hysteroscopy an. Biopsy/gross specimen was obtained (as the case may be) and subjected to histo-pathological evaluation.
Result
On hysteroscopy, a maximum number of cases (n=48, 55.81%) had no abnormal pathology (24 proliferative, 15 secretory and 9 atrophic). A total of 7 (8.13%) cases were diagnosed to have polyp, 3 (3.48%) had calcified endometrium, 11 (12.79%) had submucous myoma, 2 (2.32%) had necrotic mass, one had adhesions, and two had forgotten IUCD. However, on histopathology, 56 (65.11%) cases had normal/proliferative/atrophic endometrium, 17 (19.76%) had hyperplasia, 3 (3.48%) had calcified endometrium, and 10 (11.62%) had polyp. No significant difference between two modalities was observed with respect to number of normal/ proliferative/ atrophic endometrium. Statistically, no significant difference between two modalities was observed with respect to other pathologies. Overall there was 62.7% agreement between histopathology and hysteroscopy.
Conclusion
The findings of the study suggested that hysteroscopy was quite useful in diagnosis of abnormal uterine bleeding. Although it had an agreement with histopathology to the extent of 62.9% only, it provided additional information for pathologies that remained undiagnosed on histopathology. Hence it is essential that it should be made essential part of diagnostic workup of cases of
abnormal uterine bleeding.