Role of Hysteroscopy in Evaluation of Patients with Abnormal Uterine Bleeding

Abstract

The aim of this study was to assess the feasibility of hysteroscopy for identifying abnormal findings in uterine cavities of pre- and postmenopausal women presented with abnormal uterine bleeding and to correlate the hysteroscopic with histological findings. 
The study involved 239 female patients referred to the Clinic for Gynecology and Obstetrics in Niš in the period of 12 months for abnormal uterine bleeding. Hysteroscopy with endometrial biopsy were performed in all patients. Biopsy mate
rials were directed to histological examination, and the hysteroscopic and histological findings were compared afterwards. The polyps and submucous miomas were hysteroscopically removed in the same setting and also directed to histological 
examination. 
The success rate of the method was close to 98%, while complications occurred in 0,85 % of the cases. The hysteroscopic findings were normal in 41% of the cases. Submucous myoma was the most common finding in premenopausal and endometrial polyp in postmenopausal women. The sensitivity of hysteroscopy in the detection of intrauterine pathology was 100%, the specificity was 91%, the positive predictive value was 93% and the negative predictive value was 100%.
Hysteroscopy is a safe, highly sensitive diagnostic procedure that provides useful information about the uterine cavity and represents an ideal method in evaluation of patients with abnormal uterine bleeding. Endometrial biopsy improves the diagnostic accuracy of hysteroscopy in detecting endometrial pathology. Adequate diagnosis is crucial for the selection of relevant treatment of abnormal uterine bleeding and avoidance of unnecessary major surgical procedures. 

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