Abstract

Abnormal uterine bleeding is a common clinical presentation in gynaecology OPD .it amounts to 35% of gynae OPD visits and 25% of gynaecological surgeries and this incidence rises to 65% in peri and postmenopausal age(1)

Traditionally sonography and D&C have been standard methods for diagnostic evaluation of AUB and hysterectomy the sole method of treatment. this study outlines the place of hysteroscopy and its role in evaluation and management of AUB .

The use of D&C for evaluation of the uterine cavity in cases of AUB is an inaccurate method for diagnosing most common pathologic conditions associated with menorrhagia like endometrial polyps, Submucous myomas, and focal endometrial abnormalities including adenocarcinoma  Hysteroscopy enables see and treat option as the intracavitary pathology can be seen and biopsied and also removed if localized lesion.

Hysterectomy as a treatment option for all cases of AUB is no longer accepted either by patients or by service providers and more and more methods of conservative surgical options or nonsurgical options are being explored .for which accurate diagnosis is a must and also malignancy has to be ruled out with considerable surety. hysterectomy is a major surgical procedure with its associated morbidity and cost associated with it and if uterus is not at fault is an overtreatment for those pathologies  which can be treated with much simpler and minimally invasive treatment options like hysteroscopic procedures .

Use of hysteroscopy and directed biopsy ensures the recognition as well as removal of these intracavitary  lesions. in most cases of endometrial polyps and submucous myomatous polyps there is considerable reduction in bleeding after hysteroscopic removal of these lesions and if no associated endometrial pathology found then hysterectomy can be avoided in these women .thus hysteroscopic management helps in both diagnosis as well as management of a considerable no. Of women with AUB .and helps in reducing unnecessary hysterectomies.