Comparative study between the hysteroscopic and histological diagnosis of patients with abnormal uterine bleeding during menacme

Abstract

Objective: The objective of this research was to evaluate the feasibilityand the diagnostic properties of hysteroscopy in a population of womenduring menacme with the complaint of abnormal uterine bleeding,comparing endoscopic with histological findings. Methods: The studywas retrospectively conducted in 314 outpatients submitted tohysteroscopy. Every woman was submitted to guided endometrialbiopsy, using a 3 or 5mm-diameter Novak curette. The hysteroscopesused were of 3 or 5mm caliber which image was reproduced in ascreen by means of an endocamera. The results of hysteroscopic andhistological exams were compared. Results: There were noabnormalities of the uterine cavity in 151 patients (48%). Submucousmyoma was the most frequent alteration found in 45 women (14.3%).Malignancy was detected in nine patients, out of which seven hadhistological confirmation. Sensibility and specificity of hysteroscopywere respectively: a) 86.3% and 75.9% for abnormal uterine cavity; b)100% and 99.4% for malignancy, and c) 57.7% and 88.5% for endometrialhyperplasia. Five patients (6.6%) were not submitted to hysteroscopydue to cervical stenosis. Two percent of the cases presented vagalreactions, such as sweating, nausea and dizziness, with short-timerecovery. Conclusions: For higher sensitivity and specificity, diagnostichysteroscopy should be complemented with histology of theendometrial biopsy. This procedure should be considered in the workupof patients at menacme with complaints of abnormal uterinebleeding.

Keywords

• Hysteroscopy
• Uterine hemorrhage/pathology
• Comparative study