A Clinical Study of Diagnostic Hysteroscopy in Abnormal Uterine Bleeding and Its Histopathological Correlation

Abstract

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. METHODS This is a prospective study. 100 cases with abnormal uterine bleeding (AUB) underwent hysteroscopy and biopsy was taken from suspected area. They then underwent dilatation and curettage and tissue samples were sent for histopathological examination. The findings on hysteroscopy and histopathological examination were correlated. Data obtained was subjected to statistical analysis and results derived was analysed in terms of sensitivity, specificity, positive predictive value and negative predictive value. RESULTS 42 (42%) cases with AUB were seen in the age group of 40-49. Most common symptom was menorrhagia 70 (70%) seen in the age group 40-49 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of hysteroscopy was 97.18%, 96.55%, 98.57% and 93.33% and that of histopathology was 89.13%, 96.29%, 95.34% and 91.22% respectively. All 5 cases of carcinoma diagnosed on hysteroscopy were confirmed by histopathology. CONCLUSIONS Hysteroscopy should be considered as the gold standard for diagnosis of intrauterine pathologies and it should be included in the management of AUB.