Role of Hysteroscopy in Clinicopathologic Evaluation of Abnormal Uterine Bleeding

Selvapriya Saravanan, Lakshmi Subburaj, Rajkumar Krishnasamy
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Abstract

Ab s t r Ac t Background: Hysteroscopy has been proved to have diagnostic accuracy in abnormal uterine bleeding (AUB) and helps in localizing the lesions with minimal errors. However, histopathology has been considered as the gold standard in evaluating the pathological causes of AUB. The reliability of hysteroscopy as a single procedure to manage AUB has not been explored so far. This study was carried out to evaluate the validity of hysteroscopy in the diagnosis of AUB. Materials and methods: This cross-sectional study was carried out among 50 patients diagnosed with AUB. Hysteroscopy was performed along with curettage and the tissue obtained was sent for histopathological examination. All the participants underwent diagnostic hysteroscopy and hysteroscopic-guided curettage. The hyseroscopic findings were correlated with histopathological findings. Results: We observed that hysteroscopy was an effective diagnostic tool for detecting endometrial hyperplasia, with a specificity of 93% and negative predictive value of 90.1%. As far as polyps were concerned, we observed that hysteroscopy was an effective screening and diagnostic tool of detecting polyps, with a sensitivity of 93.3% and specificity of 82.8%. Conclusion: Because the histopathological findings significantly correlated with the hysteroscopy findings, we are of the opinion that hysteroscopy may as well replace the traditional dilatation and curettage and at the same time replace invasive procedures for endometrial sampling.
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宫腔镜在异常子宫出血的临床病理评价中的作用
背景:宫腔镜在异常子宫出血(AUB)诊断中具有较高的准确性,有助于定位病灶,误差最小。然而,组织病理学一直被认为是评价AUB病理原因的金标准。宫腔镜作为治疗AUB的单一手段的可靠性迄今尚未得到探讨。本研究旨在评估宫腔镜在AUB诊断中的有效性。材料和方法:本横断面研究在50例诊断为AUB的患者中进行。宫腔镜和刮宫术同时进行,取组织送组织病理学检查。所有的参与者都进行了诊断性宫腔镜检查和宫腔镜引导下的刮宫检查。浆液镜检查结果与组织病理学结果相关。结果:我们发现宫腔镜是检测子宫内膜增生的有效诊断工具,其特异性为93%,阴性预测值为90.1%。就息肉而言,我们观察到宫腔镜是发现息肉的有效筛查和诊断工具,其敏感性为93.3%,特异性为82.8%。结论:由于组织病理学检查结果与宫腔镜检查结果有显著相关性,我们认为宫腔镜检查完全可以取代传统的子宫内膜扩张刮除,同时也可以取代侵入性的子宫内膜取样。
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