OP07.06: Hysteroscopy in patients with abnormal uterine bleeding and normal transvaginal sonography

Barati, Mojgan; Masihi, Sara; Moramezi, Farideh; Salemi, Souzan

doi:10.1002/uog.5681

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…When we look at the subset of patients found to have normal endometrial cavity on TVS, we find that 55 out of 57 patients were actually found to have normal uterine cavity on hysteroscopy giving a high accuracy of 96.55% to TVS. In the thickened endometrium TVS subgroup, of the 19 patients, 16 were actually seen to have polypoidal endometrium on hysteroscopy (accuracy 84.21%) but on 2 occasions, it was in fact an endometrial polyp and once it turned out to be a normal uterine cavity. In the endometrial polyp subset of patients on TVS, 13 out of 16 patients were found to have polyps, two were found to have just polypoidal endometrium and one had normal uterine cavity.…”

Section: Resultsmentioning

confidence: 98%

“…Indman et al 14 studied 238 patients with AUB and found the negative predictive value of TVS to be 89%. Barati et al, 16 however, found that only 21.8% patients with AUB with normal TVS findings were found to have some abnormality on hysteroscopy and recommended that even after a normal TVS, a second-step office hysteroscopy should be considered. In our study, we found the positive predictive value of TVS to be as high as 93.01% which compares well with the findings of Vercellini et al (89%) and Indman et al (87%).…”

Section: Discussionmentioning

confidence: 99%

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Transvaginal sonography versus hysteroscopy in evaluation of abnormal uterine bleeding

Goyal

Gaur

Sharma

et al. 2015

Medical Journal Armed Forces India

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Abnormal uterine bleedingTransvaginal sonography Hysteroscopy Endometrial polyp Submucous fibroid a b s t r a c t Background: Abnormal uterine bleeding (AUB) accounts for 33% of female patients referred to gynaecologists. Common causes of AUB include endometrial polyps, endometrial hyperplasia, submucous fibroids and anovulation. Accurate diagnosis of the cause of AUB can reduce the frequency of hysterectomy. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Methods: 100 female patients with AUB were enrolled in the study. Each patient was subjected to TVS where uterine cavity was studied in detail and hysteroscopy under anaesthesia using saline as distension medium. Sensitivity, specificity and predictive value of TVS as compared to hysteroscopy were calculated. Subgroup analysis within each group was also performed. Results: Menorrhagia was the commonest presenting symptom in the study population (n ¼ 58) followed by metrorrhagia, menometrorrhagia and continuous bleeding >21 days. 74 female patients had normal size uterus. In 57 patients, the uterine cavity was normal on TVS. Thickened endometrium, endometrial polyp and submucous fibroids were seen in 19, 16 and 6 patients respectively. Hysteroscopy showed normal cavity in 59 female patients and polypoidal endometrium, polyps or submucous fibroids in 41. TVS was found to have high sensitivity and specificity (95.23 and 94.82 respectively) and high positive and negative predictive value. Strength of agreement between TVS and hysteroscopy was high (kappa value 0.898). Conclusion: TVS is recommended as first line investigation in AUB. If TVS shows normal cavity, further evaluation can be omitted and patient started directly on medical treatment for her symptoms.© 2014, Armed Forces Medical Services (AFMS). All rights reserved. m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 1 ( 2 0 1 5 ) 1 2 0 e1 2 5http://dx

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Transvaginal sonography versus hysteroscopy in evaluation of abnormal uterine bleeding

Goyal

Gaur

Sharma

et al. 2015

Medical Journal Armed Forces India

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“…The study of Allameh et al 18 presents the results 100% sensitivity of hysteroscopy and specificity of 80.5%, the study of Tandulwadkar et al 19 , 97% and 98%, and Barati et al 20 , 98.7% and 99%, respectively. The study of Allameh et al 18 presents the results 100% sensitivity of hysteroscopy and specificity of 80.5%, the study of Tandulwadkar et al 19 , 97% and 98%, and Barati et al 20 , 98.7% and 99%, respectively.…”

Section: Discussionmentioning

confidence: 96%

The role of hysteroscopy in diagnosis and treatment of postmenopausal bleeding

Pop-Trajkovic-Dinic

Ljubić²,

Kopitović

et al. 2013

VOJNOSANIT PREGL

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Hysteroscopy is a safe, highly sensitive diagnostic procedure, thus being an ideal method for evaluation of patients with postmenopausal bleeding. The application of hysteroscopy with endometrial biopsy leads to accurate diagnosis. An adequate diagnosis is crucial for the selection of relevant treatment of postmenopausal bleeding and avoidance of unnecessary major surgical procedures. Except for being a diagnostic method hysteroscopy, is also an outpatient minimally invasive surgical procedure for treating the cause of bleeding in the majority of cases in the same sitting.

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“…Plenty of authors till today have managed to demonstrate the great potential of hysteroscopy as the gold standard method for the investigation of women with such pathology. Barati et al have announced that in a sum of 147 women with AUB and normal TVS, 32 of them (21.8%) were hysteroscopically abnormal, and cervical canal polyp has been described as the commonest lesion that has been misdiagnosed by TVS [1]. Endometrial or cervical polyps can be treated better by hysteroscopy since D&C has proved to be less effective [2].…”

Section: Introductionmentioning

confidence: 98%

Indications of diagnostic hysteroscopy, a brief review of the literature

et al. 2011

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Plenty of authors propose outpatient hysteroscopy\ud as the gold standard diagnostic method for the\ud evaluation of endometrial pathology. This statement has\ud been strengthened in the recent years due to the wide use of\ud smaller diameter hysteroscopic devices, which have made\ud the dilation of the cervix and the use of anesthesia\ud unnecessary. The main purpose of this paper is to\ud summarize the indications of diagnostic hysteroscopy. In\ud this review, we used the most recent publications in\ud MEDLINE and Cochrane Library in order to specify the\ud indications of diagnostic hysteroscopy and the experience\ud that have been obtained till today in the management of\ud certain pathological uterine conditions. The key words we\ud used were diagnostic hysteroscopy, abnormal uterine\ud bleeding, infertility, endometrial cancer. Hysteroscopy provides\ud an accurate method of evaluation and direct visualization\ud of the endometrial cavity and moreover directed biopsy\ud and sampling of suspected lesions. Last years with the\ud continuous development in the hysteroscopy devices, plenty\ud of women benefit surgical hysteroscopy techniques for uterine abnormalities. Hysteroscopy is useful for the diagnosis in\ud patients with abnormal uterine bleeding, with endometrial\ud cancer and in infertile women. Hysteroscopy has the unique\ud advantage of combining a thorough procedure with great\ud diagnostic accuracy. The only disadvantage is that hysteroscopy\ud requires specific teaching and training and has a long\ud learning curve

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OP07.06: Hysteroscopy in patients with abnormal uterine bleeding and normal transvaginal sonography

Cited by 7 publications

References 9 publications

Transvaginal sonography versus hysteroscopy in evaluation of abnormal uterine bleeding

Transvaginal sonography versus hysteroscopy in evaluation of abnormal uterine bleeding

The role of hysteroscopy in diagnosis and treatment of postmenopausal bleeding

Indications of diagnostic hysteroscopy, a brief review of the literature

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