Parul Sinha1, Nidhi Yadav1, Uma Gupta1,2. 1. 1Era's Lucknow Medical College, Lucknow, India. 2. 2Mayo Institute of Medical Sciences, Lucknow, India.
Abstract
Purpose of the Study: To assess the efficacy of hysteroscopy in diagnosis of AUB. Method: 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. Results: 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 hyperplasia, 7 (12.5%) had calcified endometrium, and 12 (21.4%) had polyp. No significant difference between two modalities was observed with respect to number of normal/proliferative/atrophic endometrium (p = 0.185). Histopathology diagnosed hyperplasia in significantly higher proportion of patients as compared to hysteroscopy (p = 0.042). Hysteroscopy diagnosed significantly higher proportion of patients with submucous myoma (p = 0.012) and necrotic mass (p = 0.042). Statistically, no significant difference between two modalities was observed with respect to other pathologies (p > 0.05). Overall agreement between two modalities was 62.5%. For pathological abnormalities in general, hysteroscopy had sensitivity, specificity, PPV, NPV and accuracy values of 78.3, 63.6, 60, 80.8 and 69.6%, respectively. Conclusion: Hysteroscopy provided additional information for some of the pathologies, otherwise remaining undiagnosed by HPE.
Purpose of the Study: To assess the efficacy of hysteroscopy in diagnosis of AUB. Method: 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. Results: 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 hyperplasia, 7 (12.5%) had calcified endometrium, and 12 (21.4%) had polyp. No significant difference between two modalities was observed with respect to number of normal/proliferative/atrophic endometrium (p = 0.185). Histopathology diagnosed hyperplasia in significantly higher proportion of patients as compared to hysteroscopy (p = 0.042). Hysteroscopy diagnosed significantly higher proportion of patients with submucous myoma (p = 0.012) and necrotic mass (p = 0.042). Statistically, no significant difference between two modalities was observed with respect to other pathologies (p > 0.05). Overall agreement between two modalities was 62.5%. For pathological abnormalities in general, hysteroscopy had sensitivity, specificity, PPV, NPV and accuracy values of 78.3, 63.6, 60, 80.8 and 69.6%, respectively. Conclusion: Hysteroscopy provided additional information for some of the pathologies, otherwise remaining undiagnosed by HPE.
Authors: Kevin D Frick; Melissa A Clark; Donald M Steinwachs; Patricia Langenberg; Dale Stovall; Malcolm G Munro; Kay Dickersin Journal: Womens Health Issues Date: 2009 Jan-Feb
Authors: Geir Bredholt; Monica Mannelqvist; Ingunn M Stefansson; Even Birkeland; Trond Hellem Bø; Anne M Øyan; Jone Trovik; Karl-Henning Kalland; Inge Jonassen; Helga B Salvesen; Elisabeth Wik; Lars A Akslen Journal: Oncotarget Date: 2015-11-24