Abstract
AUB is the most common complain of reproductive age group women. In this study the causes & findings of AUB were compared by performing hysteroscopy & D & C and their histopathology also compared thoroughly .
Materials & Methods: This study was a prospective study carried out in SCB medical college, a tertiary care hospital in Odisha, from Aug 2013 to Aug 2015 for 2 years. 200 cases were selected for this study aging 18 years and above with menstrual irregularities. Hysteroscopy was performed in 100 patients, endometrial biopsy was taken during the procedure & sent for HP study. In another 100 patients, D & C was performed & sent for HP study as control basis. The findings on hysteroscopy and D & C and there HP reports were correlated and compared.
Results: On hysteroscopy , out of 100 cases , 32 % came as proliferative , 16 % secretory ,16 cases as sub mucous fibroid , 13 cases as endometrial hyperplasia ,8 cases as endometrial atrophy, 4 cases as endometrial adhesion ,1 case as CuT in situ & 1 case of endometrial carcinoma whereas HP study on same patients came as 43 % as proliferative, 20 % as secretary, 18 % as hyperplasia, 6% as endometrial polyp,4% as atrophic endometritis, 2 % as fibroid polyp, 1% absent endometrium & 1% as endometrial carcinoma . Another 100 patients on whom blind D & C were performed came as 52 % as proliferative, 20 % secretory, 19% as endometrial hyperplasia, 6% as atrophic endometrium and 3 % as endocervical polyp.
Conclusion: In patients with AUB, hysteroscopy provides more accurate and detailed diagnosis than dilatation and curettage alone. Especially endometrial cavity lesions are more accurately diagnosed by hysteroscopy and also in similar setting; therapeutic procedures can be performed than the blind D & C procedure.
Keywords: D & C – dilatation and curettage, HP report – histopathological report, DH – diagnostic hysteroscopy.
References
- Advincula AP, Wang K. Evolving role and current state of robotics in minimally invasive gynecologic surgery. J Minim Invasive Gynecol. 2009 May-Jun. 16(3):291-301. [Medline].
- Swanström LL. Natural orifice transluminal endoscopic surgery. Endoscopy. 2009 Jan. 41(1):82-5.[Medline].
- Bosteels J, Van Herendael B, Weyers S, D'Hooghe T. The position of diagnostic laparoscopy in current fertility practice. Hum Reprod Update. 2007 Jun 11. [Epub ahead of print]. [Medline]
- Taneja SP. Hysteroscopy: Past, present and future. Med J Armed Force India. 2002; 58:293–4
- Obstet Gynaecol India. 2011 Oct; 61(5): 546–549.Published online 2011 Nov8. doi: 1007/s13224-011-0088-6 PMCID: PMC3257342Hysteroscopy in Evaluation of Abnormal Uterine Bleeding Gita Guin, Surpreet Kaur Sandhu, Arvind Lele, and Shashi KhareDepartment of Obstetrics and Gynaecology, Government N.S.C.B. Medical College, 436, Kamla Nehru Nagar, Garha Road, Jabalpur, MP 482 002 India Gita Guin, Phone:+09300115875, Email: ni.oohay@6691niug_atig
- J Gynaecol Endoscopic surg 2009 july-dec ; 1 (2) : 98-104 sheetal G Patil , S B Bhute , S A Inamdar , Neema S Acharya .
- Scientific journal of faculty of medicine in NIS , 2011 , 28 (3) : 177-181, Sonja Pop , Trajkovic Dinic , Vesna Kopitovic , Vladimir Antic .
- Loverro G , Bettocchi S , Carmio G , Nicolardi V , Porreca MR , Pansini N et al.diagnosic accuracy of hysteroscopy in endometrial hyperplasia .Maturitas .1996;25:187-9 (pubmed)
- Arslan S , Aytan H , Gunyeli I , Koi O , Tuncay G , Tapisiz OL .Office hysteroscopic evaluation of endometrium ; can we hit the target. Arch Gynecol Obstet.2004;271:200-2 (pubmed)
- Panda A , Parulekar SV , Gupta A , Diagnostic hysteroscopy in AUB and its HP correlation . J Obstet Gynaecol India .1999; 49 :74-76
- Acharya V , Mehta S , Randar A .evaluation of Dysfunctional uterine bleeding by TVS , Hysteroscopy and Hystopathology . J Obstet Gynaecol India .2003:53;170-7
- Valle RF , Hysteroscopic evaluation of patients with AUB .Surg Gynecol Obstet. 1981;153:521-6 (pubmed)
- Sheth S , Hamper VM < Kurman R , et al . A study between hysteroscopy with directed biopsies and dilatation and curettage. Am j Obstet Gynaecol1989 ;158:489
- Mencaglia L. Hysteroscopy and adenocarcinoma. Obstet Gynecol Clin north Am .1995 ; 22 :573-9 ( pubmed )
- Haller H , Maechjcic N , Rukarina B , Krasevic M , Rupcic S , Mozetic D. transvaginal sonography and hysteroscopy in woman with postmenopausal bleeding . int J Gynaecol Obstet .1996 ; 54; 155-9 ( pubmed).
- Hulka JF, Peterson HB, Phillips JM, et al. Operative hysteroscopy. American Association of Gynecologic Laparoscopists 1993 membership survey. J Am Assoc Gynecol Laparosc 1995 Feb;2(2):131-2. Abstract
- Asher Shushan, M.D.a, , Athanasios Protopapas, M.D.a, Roger Hart, MRCOGa, Adam L. Magos, M.D., FRCOG
Corresponding Author
Dr Jyoti Narayan Puhan
Resident Doctor (MS O G), SCB Medical College, Cuttack, Odisha, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i9.73
