Search

Title: See and Treat Hysteroscopy in Evaluation and Management of Abnormal Uterine Bleeding: Our Experience at a Rural Teaching Hospital of Chhatisgarh

Authors: Naik Meena MD, MRCOG, Thaore Swati, Ratnani Rekha

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i9.155

{tab 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.

 

{tab References}

  1. Luigi Man, Paulo Vercellini.role of TVS and outpatient diagnostic hysteroscopy in evaluation of AUB.clinics of Obstetrics and gynaecology.2014.Available at :http://endometriosis .org/.
  2. Mencaglia L, Perino A, Hamou J. Hysteroscopy in perimennopausal and postmenopausal women with abnormal uterine bleeding. J Reprod Med 1987;32:577- 582.
  3. Bradlow J, Coulter A, Brooks P. Patterns of referral. A study of referrals to out-patient clinics from general practitioners in the in the Oxford region. Oxford: Oxford Health Services Research Unit, 1992.
  4. Brill A. What is the role of hysteroscopy in the management of abnormal uterine bleeding? Clinical Obstet Gynecol 1995;38:319-45
  5. Fung T, Lam M, Wong S. A randomised placebo controlled trial of vaginal misoprostol for cervical priming before hysteroscopy in postmenopausal women. Int J Obstet Gynecol 2002;5:561-5.
  6. Cameron S, Walker J, hambers S. Comparison of Transvaginal ultrasound, saline infusion sonography and hysteroscopy to investigate postmenopausal bleeding and unscheduled bleeding on HRT. Aust NZ J Obstet Gynecol 2001;3:291-4
  7. Epstein E, Ramirez A, Skoog L, Valentin L. Dilatation and curettage fails to detect most lesions in the uterine cavity in women with postmenopausal bleeding. Acta Obstet Gynecol 2001; 12:1131-6
  8. Grimes D. Diagnostic dilatation and curettage of reappraisal. Am J Obstet Gynecol 1982;47:300-6
  9. Chaudhari KR et al. Int J Reprod Contracept Obstet Gynecol. 2014 Sep;3(3):666-670
  10. Sonja Pop Trajkovic. Role of hysteroscopy in evaluation of patients with AUB. Clinic for gynecology and obstetrics, clinic centre Serbia. Sci J Faculty Med. 2011;28 (3):177-81.

{tab Corresponding Author}

Naik Meena MD, MRCOG

Asst Professor, Dept of Obgyn, CCM Medical College,

Kachandur, Durg, Chhatisgarh

{tabs}

Call For Paper Volume 12 Issue 12 December 2024

The JMSCR is accepting manuscripts for its coming issues to be Publish Volume 12 Issue 12 December 2024 the JMSCR invites authors to submit manuscripts Reporting original medical research, original article, research article, case report, systematic reviews, or educational Innovations for publication for the coming issues that will be released in Volume 12 Issue 12 December 2024. Types of manuscripts suitable for JMSCR include: Medical research, Clinical research Educational Innovation, Brief Report, Reviews on Teaching In keeping with high quality scholarship, Read More.....

https://jmscr.igmpublication.org/ems/index.php/jmscr/about/submissions

If any difficulty you can also submit to: This email address is being protected from spambots. You need JavaScript enabled to view it.

Editorial Policy

Authors should prepare their manuscripts according to the instructions given in the authors' guidelines. Manuscripts which do not ..

Read More.....

Frequency of Publication

JMSCR is published as monthly journal with 12 issues per year. Special editions are also planned subjected to the scope and need....

Read more...

Submission of Articles

Authors are invited to submit their research articles, review papers, Case Report properly formatted as per the author guidelines.........

Read more...

Go to top