Hysteroscopy In Abnormal Uterine Bleeding Research Articles

Ambulatory Hysteroscopy in Abnormal Uterine Bleeding: A Tertiary Care Hospital Perspective

Background: To avoid delays in outpatient facilities for managing benign gynecological conditions like abnormal uterine bleeding (AUB), there is a need to evaluate the usage of unconventional methods like outpatient hysteroscopy. Objectives: To evaluate the usage of outpatient diagnostic hysteroscopy in women with abnormal uterine bleeding. Methods: An observational study was conducted at the Obstetrics and Gynecology Department of Combined Military Hospital, Kharian. The study included 56 women having AUB with or without a history of failed medical treatment. The study participants underwent outpatient diagnostic hysteroscopy. Diagnostic hysteroscopy was done under the local para-cervical block in the Outpatient department. Procedure indications, outcome and biopsy findings were recorded on predesigned proformas. Results: Median age of the study participants was 44 years. The most common indications for diagnostic hysteroscopy were postmenopausal bleeding (34%) and heavy menstrual bleeding (28%). Hysteroscopy outcomes included endometrial biopsy (34%), discharge with no biopsy (25%), further test and evaluations required (21%), and admission due to failed outpatient procedures (20%). Sixty-two percent of the study participants had normal biopsy findings while other biopsy findings included polyps (20%), fibroids (14%) and endometrial hyperplasia (4%). Nine percent had unsuccessful hysteroscopy due to patient refusal to proceed. Conclusion: Outpatient hysteroscopy can be helpful in the early and rapid diagnosis of women with abnormal uterine bleeding.

Diagnostic Value of Vaginal Ultrasound under Improved Clustering Algorithm Combined with Hysteroscopy in Abnormal Uterine Bleeding.

In order to explore the diagnostic value of the improved clustering algorithm of vaginal ultrasound combined with hysteroscopy in abnormal uterine bleeding (AUB), 128 patients diagnosed with AUB in the hospital were selected as the research objects. A K-means improved clustering color image segmentation algorithm was designed and applied to AUB vaginal ultrasound image processing. The running time, mean square error (MSE), and peak to signal noise ratio (PSNR) were calculated to evaluate the algorithm, and the sensitivity, specificity, negative likelihood ratio, and positive likelihood ratio were used to evaluate the diagnostic accuracy of the detection method. In addition, combined with hysteroscopy, a comprehensive evaluation of the diagnostic value of abnormal uterine bleeding diseases was implemented. The results showed that compared with the traditional K-means clustering algorithm, the running time of the improved K-means clustering color image segmentation algorithm in the training set was significantly shortened, the MSE was significantly decreased, and the PSNR was significantly increased (P < 0.05). The sensitivity, specificity, negative likelihood ratio, and positive likelihood ratio (90.5%, 93.2%, 84.3, and 96.3%) of AUB diagnosis were significantly improved in the algorithm of vaginal ultrasound combined with hysteroscopy (P < 0.05). In summary, the combination of vaginal ultrasound and hysteroscopy based on K-means improved clustering color image segmentation algorithm can significantly improve the clinical diagnostic accuracy of AUB patients.

Diagnostic hysteroscopy is a better method for diagnosis and management of abnormal uterine bleeding than traditional methods – An Indian perspective

Introduction: Abnormal uterine bleeding (AUB) is one of the common problems affecting at least one fourth women in reproductive age group. Currently transabdominal and transvaginal sonography is the most commonly used primary screening modality, whereas uterine dilatation and curettage (D&amp;C) is most the commonly used technique for diagnosis and obtain uterine biopsy. However they have various disadvantages. Diagnostic hysteroscopy and biopsy is gradually emerging as the gold standard for AUB. This study evaluates the role of hysteroscopy in diagnosing various intrauterine pathologies. Materials and methods: This study was a hospital record based retrospective observational study. Data of 172 patients who underwent hysteroscopy for AUB were included and hysteroscopic diagnosis was compared with final histopathology to find out the sensitivity, specificity and positive predictive value of hysteroscopy for diagnosing various common intrauterine pathology. Results: Results show that hysteroscopy has high sensitivity and specificity for diagnosis of intrauterine pathology. The study results are in concordance with the findings in few other similar studies. Conclusion: The authors recommend preferring use of this technique over traditional D&amp;C for both diagnostic and therapeutic indications in AUB. Keywords: metrorrhagia, hysteroscopy; uterine; dilatation; curettage

STUDY OF DIAGNOSTIC HYSTEROSCOPY IN PERI AND POSTMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING

Background:Abnormal uterine bleeding is dened as bleeding from uterus that differs from that of usual normal menstrual bleeding, in frequency of occurrence or in amount or in alteration of ow. The advantages of hysteroscopy as an accurate diagnostic technique are that it not only allows direct visual observation of pathology but also provides a means to sample the site, most likely to yield positive results. The present study was conducted to study the role of Hysteroscopy in abnormal uterine bleeding in Peri and Post-menopausal women at a tertiary care hospital. Material And Methods: Present study was single-center, prospective, Cross sectional study, conducted in women age ≥40years with heavy menstrual bleeding, prolonged bleeding, frequent menstruation, intermenstrual bleeding and post coital bleeding, Post-menopausal bleeding. Hysteroscopy was performed preferably in post-menstrual phase or post bleeding phase with a standard 4mm hysteroscope(Stryker) with a 30 degree fore-oblique lens. Procedure was performed under IV sedation with normal saline as distention media. Results: In present study, majority of the subjects (n=28) i.e. 36.8% presented with heavy menstrual bleeding followed by prolonged bleeding (32.8%), post- menopausal bleeding (21%), frequent menstruation (7.89%) and inter-menstrual bleeding (1.3%). On hysteroscopy normal ndings were present in 32 subjects (42%) followed by hyperplasia (17.1%), atrophic endometrium (13.1%), submucous broid (14.4%), endometrial growth (2.96%) &amp; broid polyp (1.36%). Histopathology examination noted Proliferative endometrium (31.5%), secretory (10.5%), disordered proliferative phase (1.3%), simple hyperplasia (18.4%), complex hyperplasia with atypia (1.3%), submucous broid (14.4%), endometrial polyp (34.2%), atrophy (13.1%), broid polyp (1.34%) and malignancy (3.96%). Sensitivity, Specicity, PPV, NPV values were 100 % except for sensitivity for endometrial growth (66.7 %). p Value was highly signicant for all parameters (p &lt;0.0001) Conclusion: Hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.. The intracavitary lesions (submucous leiomyomas, polyps, endometrial growth are) better diagnosed on hysteroscopy

Video Hysteroscopy in the Diagnosis of Molar Pregnancy in two Challenging Situations: Complete Mole with Normal hCG and Partial Mole with Early Gestational Age

To present the first hysteroscopic findings of 2 cases of complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) within the context of the patients' clinical histories. Presentation of 2 hysteroscopic videos with narration of the intrauterine findings of molar pregnancy (MP) from Rio de Janeiro Gestational Trophoblastic Disease Reference Center. MP is characterized by abnormal fertilization that generates 2 clinical syndromes: CHM and PHM [1]. In the first case, the patient was aged 50 years, and hysteroscopy was indicated to assess abnormal uterine bleeding in the presence of normal serum human chorionic gonadotropin (hCG) and transvaginal ultrassonography showing an endometrial cavity with heterogeneous content. Hysteroscopy found translucent hydropic structures diagnosed as CHM. The negative hCG value was due to the hook effect (hCG after dilution: 2 240 000 IU/L). In the second case, an 18-year-old patient underwent hysteroscopy to assess the endometrial cavity with retained abortion at 7 weeks in which, during conservative management, the hCG level increased over 4 weeks from 25 000 IU/L to 58 000 IU/L. Hysteroscopy visualized the embryo with its umbilical cord and hydatidiform vesicles diagnosed as PHM. MP can be an incidental finding during hysteroscopy for abnormal uterine bleeding or retained abortion [2-4]. Knowing its morphology during hysteroscopy is helpful for the correct management of this uncommon clinical situation. Hysteroscopy as an adjunct diagnostic tool (not as first-line treatment for MP) can be of significant benefit in challenging clinical scenarios. Further studies should assess the possible risk of spreading molar cells into the peritoneal cavity owing to hysteroscopic fluid.

Role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation

Role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation

Role of Diagnostic Office Hysteroscopy in Abnormal Uterine Bleeding and its Histopathological Correlation in Child Bearing Period

Strange uterine draining characterized as a seeping from uterine form which is irregular in volume, routineness or potentially timing that has been available for most of the most recent a half year. Assessment of the patients was by history taking, general and nearby assessment, research facility examinations, transvaginal ultrasonography, hysteroscopy and dilatation and curettage with biobsy. To evaluate the Role of Office Hysteroscopy in finding of Abnormal Uterine Bleeding and its Histopathological Correlation in Child Bearing Period. This examination was imminent observational investigation carried on 100 ladies of conceptive age bunch from 18-40 years took care of Benha college emergency clinics between November 2018 to November 2020 to assess the symptomatic and restorative function of office hysteroscopy in anomalous uterine draining and its histopathological connection in ladies inside kid bearing period. Office hysteroscopy had affectability of 88%, explicitness of 84,2%, positive prescient estimation of 96%, negative prescient estimation of 61.5% and demonstrative precision of 87% for diagnosing the intrauterine reason for unusual uterine dying. Office hysteroscopy is a straightforward, essential and generally safe outpatient strategy which permits a satisfactory investigation of the uterine cavity under visual control.

Hysteroscopy in Abnormal Uterine Bleeding

Aims: To evaluate the role of hysteroscopy in abnormal uterine bleeding in women of reproductive age group and to correlate the hysteroscopic findings with histopathology.&#x0D; Methods: The study was carried out in the Department of Obstetrics and Gynecology at Patan Academy of Health Sciences, Kathmandu. Thirty patients of age group 20-61years with abnormal uterine bleeding were included. Demonstrable pelvic pathology like cancer of cervix, vagina or endometrium and active pelvic inflammatory disease (PID) were excluded. All patients were assessed using hysteroscopy and findings were correlated with histopathology.&#x0D; Results: On hysteroscopy, endometrium was normal in 30%, hyperplastic in 30%, polyps found in 20% and atrophic in 10%. Endometrial polyp and submucous fibroid was seen in 6.7% cases and 3.3% cases each. On confirmation by histopathology the findings were: normal endometrium in 40% cases, hyperplastic in 40%, polyp in 16.7% and atrophic in 3.3%. Submucous fibroid and suspicious endometrium came to be endometrial hyperplasia on histopathology.&#x0D; Conclusions: Hysteroscopy has more than 90% diagnostic accuracy to diagnose endometrial morphology and diagnostic agreement of endometrial finding is 63.33%.&#x0D; Keywords: abnormal uterine bleeding, hysteroscopy, predictive value

Diagnostic Hysteroscopy in Abnormal Uterine Bleeding: A Prospective Analytical study

Localized lesions like a polyp or abnormal growth can be missed by traditional dilatation and curettage whereas such intrauterine abnormalities can be easily diagnosed by hysteroscopy as we can directly visualise the cervical canal and uterine cavity. The objective of our study was to assess the diagnostic accuracy of hysteroscopy in diagnosing the cause of AUB and to correlate hysteroscopy findings with histopathology. This prospective study was conducted in women with symptoms of AUB in the reproductive, perimenopausal and postmenopausal age group who had underwent hysteroscopy over a period of 2 years. Hysteroscopic findings and histopathology findings were compared. The main symptoms for which hysteroscopy was performed was postmenopausal bleeding (44.1%) followed by menorrhagia (33.8%). Hysteroscopy detection of abnormal findings had a sensitivity 90%, specificity 87.5%, positive predictive value 98.2% and negative predictive value 53.8%. To conclude hysteroscopy improves the accuracy of diagnosing intrauterine pathologies and also helps in treating some causes of AUB by simple procedures in the same sitting thereby avoiding major surgeries.

Does temperature of distending medium matter in outpatient hysteroscopy? A double‐blinded cohort control observational study of room temperature versus warmed saline

There is little data assessing outcomes of outpatient hysteroscopy using warmed versus room temperature saline. The aim of this study was to determine if the temperature of the distending medium during outpatient hysteroscopy affect ease of procedure, clarity of view, procedural discomfort/pain and patient satisfaction. This was a double-blinded cohort control quasi-randomized prospective study involving 100 women undergoing outpatient diagnostic and operative hysteroscopy for abnormal uterine bleeding, intrauterine contraceptive devices retrieval and removal of endometrial polyps. Outpatient hysteroscopy was performed either with normal saline either at room temperature (control at 25°C) or warmed to body temperature (37°C). Confounding variables such as age, parity, previous cervical surgery, previous vaginal births, menopausal status and indications for hysteroscopy were similar in the room temperature (n = 48) and warmed saline (n = 52) groups. Mean procedure duration (256 vs 233 s), ease of entry (Visual Analogue Scale [VAS] 9.55 vs 9.4) and the clarity of view (VAS 9.02 vs 9.3) were statistically similar in both groups (all P > 0.05) as was discomfort experienced during hysteroscopy (VAS 6.6/10 vs 6.8/10) and at 5 min post-procedure (VAS 4.2/10 vs 3.2/10) (both P > 0.05). The likelihood of recommending the procedure to a friend was similar in both groups (mean VAS 6.9/10 vs 7.2/10; P = 0.1). The temperature of the distension medium did not influence ease of procedure, clarity of hysteroscopy view, procedural discomfort/pain and patient satisfaction. Patients were not any more likely to recommend the procedure to a friend in the warmed saline compared to the room temperature group.

Comparative Study of the Diagnostic Accuracy of Transvaginal Sonography vs Hysteroscopy in Abnormal Uterine Bleeding

Comparative Study of the Diagnostic Accuracy of Transvaginal Sonography vs Hysteroscopy in Abnormal Uterine Bleeding

Recurrence and prediction of abnormal uterine bleeding and re-intervention after initial hysteroscopic treatment: a retrospective cohort study.

To estimate the incidence of recurrence of complaints and repeated interventions after hysteroscopic treatment for abnormal uterine bleeding in premenopausal women and to determine potential predictors for re-intervention. This is a retrospective cohort study in two secondary care centers in the Netherlands. We included 313 premenopausal women who underwent hysteroscopy for complaints of abnormal uterine bleeding and who had intrauterine pathology visualized at ultrasound. The intrauterine structure was hysteroscopically removed. These women were compared with women who had a hysteroscopy for abnormal uterine bleeding, but in whom hysteroscopy showed no abnormalities. We used Chi-squared test for categorical variables and independent-samples T test for continuous variables. p Values less than 0.05 were considered to indicate statistical significance. In total, 262 women had intrauterine pathology removed at hysteroscopy; 136 (52%) women had recurrence of complaints, while 101 women (39%) underwent re-intervention. Heavy menstrual bleeding at baseline and multiparity were predictive factors for recurrence of abnormal uterine bleeding and re-intervention. In the 51 women with abnormal uterine bleeding in whom hysteroscopy showed no intrauterine abnormality, 29 women (60%) had recurrence of complaints and 12 (24%) a re-intervention. In premenopausal women with abnormal uterine bleeding, treatment of intrauterine pathology often does not reduce the complaints, thus questioning the effectiveness of hysteroscopic removal of these structures.

Role of Diagnostic Hysteroscopy in Abnormal uterine bleeding in perimenopausal females and its histopathological correlation

Role of Diagnostic Hysteroscopy in Abnormal uterine bleeding in perimenopausal females and its histopathological correlation

A Study of the Role of Hysteroscopy in Abnormal Uterine Bleeding

Abstract Objectives: There were two study objectives: (1) to determine the diagnostic accuracy of hysteroscopy in women with abnormal uterine bleeding (AUB) and (2) to correlate hysteroscopic and h...

Role of hysteroscopy in abnormal uterine bleeding and its histopathological correlation

Role of hysteroscopy in abnormal uterine bleeding and its histopathological correlation

Establishing patterns on hysteroscopy in abnormal uterine bleeding (AUB)

Introduction:Pattern recognition of various phases of normal endometrium and endometrial pathologies during hysteroscopy has many advantages. It would help to triage women with AUB, so as to be selective with biopsies and curettages. Recognition of normal variant or benign lesion would reduce burden to the pathologist by decreasing the number of unnecessary sampling. It will also decreases anxiety of the patient as the report/prognostication can be instant in many cases.Material and methods:This prospective, double blind, correlation study was carried out in the teaching hospital with a sample population of 70 women presenting with AUB who underwent hysteroscopy and endometrial sampling. We identified patterns of endometrium which can used to predict six endometrial pathologies which were later correlated with the final histological diagnosis.Results:There was good correlation between hysteroscopic patterns and histopathology report, 33% of starry sky appearance correlated with atrophic endometrium, 87% of tongue shaped projections correlated with endometrial polyp, 44.4% of pebble stone appearance correlated with myomatous polyp, 50% of polypoidal pattern correlated with endometrial hyperplasia. 100% correlation was seen in strawberry appearance, pattern for secretory endometrium and cerebroid appearance which was pattern designated to endometrial carcinoma.Conclusion:Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.

Hysteroscopy for Abnormal Uterine Bleeding and Fibroids

Operative hysteroscopy is a safe and effective minimally invasive treatment option for submucosal and intramural leiomyomas. We discuss preoperative evaluation, fluid management, postoperative complications, preventative measures, and hysteroscopic outcomes. Technical instructions and tips for successful hysteroscopy, as well as the various equipment options most commonly utilized in the United States, are also reviewed.

Diagnostic hysteroscopy in abnormal uterine bleeding: a five years study in Kathmandu university hospital

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Abnormal uterine bleeding is the cause of concern, inconvenience and discomfort to many ladies, this affects millions of women in both developed and developing world. Until recent times, dilatation and curettage was the usual method of evaluation .This detects the cause of bleeding in less than 50% of the cases, but hysteroscopy is a better diagnostic modality and prompt treatment can be provided in the same setting.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;A prospective study was carried out in the Department of Obstetrics and Gynecology at Dhulikhel hospital, Kathmandu University Hospital, Kavre, Nepal from January 2010 to January 2016. Two hundred and eighteen cases were enrolled in this study. Patients with abnormal uterine bleeding above the age of 18 years were enrolled. Hysteroscopic examination was done in all patients after the pregnancy was ruled out with urine pregnancy test and ultrasonology. The patients then underwent hysteroscopic guided endometrial sampling and endometrium was sent for histopathologic examination. The correlation between findings on hysteroscopy and histopathologic examination was tabulated. &lt;/span&gt;&lt;span lang="EN-IN"&gt; &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Following were the findings on hysteroscopy: proliferative endometrium was in 59%, secretary endometrium was in 14%,endometrial hyperplasia in 12%, atrophic in 2 %, endometrial polyp in 7%, submucous myoma in 5% and carcinoma of endometrium in 1%.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; In patients with abnormal uterine bleeding, hysteroscopy provides more accurate diagnosis than dilatation and curettage&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;

Hysteroscopy in Abnormal Uterine Bleeding vs Ultrasonography and Histopathology Report in Perimenopausal and Postmenopausal Women

Abnormal uterine bleeding is one of the most common morbidity landing women to attend medical attention in gynecology outpatient department. This study aims to evaluate the hysteroscopy finding in diagnosis of AUB and its correlation with ultrasonography finding and histopathological reports. This was a prospective comparative study in which ultrasonography was performed in fifty patients with abnormal uterine bleeding attending OPD then hysteroscopy was performed.After removing hysteroscopy dilation and curettage was done and sample sent for histopathology.At the end reports of hysteroscopy finding were compared with sonograhic and pathological results. In the study women aged from 45 to 64 years with the symptoms duration of 15 days to 6 months. Post menopausal women seek medical attention more early then the menstruating women.Common symptoms are menorrhagia, metrorrhagia and postmenopausal bleeding. Most common abnormality was menorrhagia (32%) followed by post menopausal bleeding 28 %. Ultrasonography showed 46% of abnormal finding in which 17 (47%) menstruating women and 6 (43%) women were postmenopausal women. Among 50 women 17 (34%) had negative finding and 43 (66%) had abnormal finding in which most common finding of hyperplastic endometrium. Hysteroscopy correctly diagnose atrophic endometrium, polyp and endometrial Ca which is also confirmed by histopathology finding. Hysteroscopy is reliable method for evaluating cases of AUB and it can be used as first line diagnostic method for benign lesions. Hysteroscopy guided biopsy has most accurate in diagnosing pathology.

Role of transvaginal sonography and diagnostic hysteroscopy in abnormal uterine bleeding.

Introduction : A prospective study was carried out in Department of Obstretics and Gynaecology in KIMS Hospital Bangalore, India, for a period of 18 mnth from 2005-2008. Sixty cases were selected for this study from patients who were above the age of 40 y and who were presented with a history of abnormal uterine bleeding (after excluding pregnancy and its complications, Patients with local causes of bleeding, patients with carcinoma cervix and PID). All women underwent transvaginal sonography and hysteroscopy. Dilatation and curettage was done in cases with abnormal endometrial findings and sample sent for histopathology examination. Performance of TVS pick up rate in relation to hysteroscopy were analysed by various statistical methods. In the present study, transvaginal ultrasound showed an accuracy of 83.3% in detecting the proliferative phase and 66.67% in detecting the secretory phase. TVS has a sensitivity of 0% for a local lesion (intra-cavitary) of endometrial cavity. TVS was also preferable in case of post-menopausal patients with endometrial thickness less than 4mm. Both TVS and hysteroscopy can detect endometrial intracavitary abnormalities with varying accuracies. These can supplement and enhance the accuracy of tissue diagnosis. Thus, the first procedure to which patients with AUB are to be subjected should be TVS followed by hysteroscopy and hysteroscopically directed biopsy, wherever required.