scholarly journals Transvaginal sonography versus saline contrast sonohysterography in evaluation of abnormal uterine bleeding

2017 ◽  
Vol 6 (10) ◽  
pp. 4437 ◽  
Author(s):  
Rashmi Vohra ◽  
Rita Mittal ◽  
Anupa Sood
Keyword(s):  
Screening Method ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Transvaginal Sonography ◽  
Promising Technique ◽  
Obstetrics And Gynaecology ◽  
Mother And Child ◽  
One Year ◽  
Operative Findings

Background: To evaluate TVS and SCSH as a screening method in case of AUB and to correlate he findings of TVS and SCSH with hysterectomy specimen.Methods: Present study was conducted in department of obstetrics and gynaecology, Kamla Nehru Hospital for mother and child, IGMC, Shimla for a period of one year. A total of 150 patients with AUB were subjected to TVS and SCSH in same sitting irrespective of their phase of menstrual cycle. All the cases were subjected to hysterectomy within 2 weeks and operative findings were noted. Data was collected and findings analysed.Results: Overall sensitivity of SCSH was found to be 97.6% while that of TVS was 95.1%. The overall specificity of SCSH was found to be 99.6% and that of TVS was 98.2%. PPV, NPV and DA for SCSH was more than that of TVS i.e., 98.9% vs 97.4%, 99.7% vs 99.3% and 99.4% vs 98.7%.Conclusions: SCSH represents a new and promising technique for investigation of the uterine cavity. It is safe, minimally invasive, easy, cost effective and reliable method to diagnose the cause of AUB.

scholarly journals Ormeloxifene in the management of dysfunctional uterine bleeding

2018 ◽  
Vol 7 (5) ◽  
pp. 1885
Author(s):  
L. Thulasi Devi ◽  
Ravi Nimonkar
Keyword(s):  
Side Effects ◽  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Brand Names ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Receptor Modulator ◽  
One Year

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg.  Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.

scholarly journals A clinicopathological study of dysfunctional uterine bleeding

2014 ◽  
Vol 4 (8) ◽  
pp. 635-638
Author(s):  
N Katuwal ◽  
G Gurung ◽  
A Rana ◽  
A Jha
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
University Teaching ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Obstetrics And Gynaecology ◽  
Proliferative Endometrium ◽  
One Year ◽  
Complete History

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638

scholarly journals Role of diagnostic hysteroscopy in evaluating patients with abnormal uterine bleeding in a tertiary care centre

2021 ◽  
Vol 10 (12) ◽  
pp. 4464
Author(s):  
Apeksha M. Mohite ◽  
Deepali S. Kapote ◽  
Michelle Fonseca
Keyword(s):  
Tertiary Care ◽  
Screening Method ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Uterine Bleeding ◽  
Systematic Evaluation ◽  
Contraceptive Device ◽  
Tertiary Care Centre

Background: Abnormal uterine bleeding is one of the commonest conditions amongst patients attending gynaecology OPD which also leads to significant disruption in a normal lifestyle. The causes of abnormal uterine bleeding are heterogeneous and complex. A systematic evaluation with detailed history and physical examination is foremost important in reaching diagnosis. Hysteroscopy is not only safe, quick and observes entire uterine cavity but also helps in precision in sampling and increases accuracy of diagnosis. It is also curative in conditions such as polyps, fibroids, uterine synechiae, menorrhagia and lost intrauterine contraceptive device. The aim of the study is to evaluate the role of hysteroscopy as a screening method in patients with AUB & compare to their USG findings and to the histopathological reports of the endometrial biopsy.Methods: This is a prospective observational study conducted at a tertiary healthcare centre over a period of 18 months, in 50 females belonging to pre, peri and post-menopausal age group. Sampling was done based on selection criteria after obtaining valid consent from the study group.Results: Hysteroscopy has a definitive role in evaluation of patients presenting with abnormal uterine bleeding with high sensitivity, specificity, PPV and NPV with immediate results.Conclusions: The above study concludes that the accuracy of diagnosing the cause of abnormal uterine bleeding is more with hysteroscopy followed by D and C then USG combined with D and C.

scholarly journals A prospective study of comparison between transvaginal sonogram and histopathological examination in perimenopausal women with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4233
Author(s):  
P. Rishma Priyanka ◽  
C. Rama Mani ◽  
A. Yamuna
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Main Concern ◽  
Dilatation And Curettage ◽  
Perimenopausal Women ◽  
Histopathological Report

Background: Abnormal uterine bleeding is one of the most frequently encountered conditions in gynaecology practice and forms about 10% of all gynaecological admissions, the main concern in perimenopausal bleeding is that the bleeding could be the only external manifestation of many hidden serious pathologies of uterine-cavity. The objective of this study was to compare the results of transvaginal sonography (TVS) and drug and cosmetic (D and C) with histopathological examination (HPE) report of hysterectomy specimen in perimenopausal women with AUB.Methods: A prospective comparative study where 100 perimenopausal women with AUB were subjected to TVS then D and C and then the results were compared with histopathological report of the hysterectomized specimen.Results: With an endometrial thickness less than or equal to 15 mm the histopathology report is normal endometrium. When the endometrial thickness more than or equal to 15 mm the histopathology report is hyperplasia or carcinoma. Findings of TVS correlated well with histopathological report after hysterectomy. 14 cases of adenomyosis, 16 cases of myomatous polyp, and 6 cases of endometrial polyp missed by dilatation and curettage.Conclusions: TVS is a simple, non-invasive test to indirectly visualize the endometrial cavity and is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. Dilatation and curettage lags in detecting adenomyosis, endometrial and myomatous polyps, When TVS combined with dilatation and curettage, it can supplement the shortcomings of dilatation and curettage.

scholarly journals The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Attilio Di Spiezio Sardo ◽  
Gloria Calagna ◽  
Fabrizia Santangelo ◽  
Brunella Zizolfi ◽  
Vasilis Tanos ◽  
...  
Keyword(s):  
Pathological Condition ◽  
Incidental Finding ◽  
Imaging Techniques ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Age ◽  
Transvaginal Sonography ◽  
Uterine Adenomyosis ◽  
Improving Accuracy

Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology. Hysteroscopy offers the advantage of direct visualization of the uterine cavity while giving the option of collecting histological biopsy samples under visual control. Hysteroscopy is not a first-line treatment approach for adenomyosis and it represents a viable option only in selected cases of focal or diffuse “superficial” forms. During office hysteroscopy, it is possible to enucleate superficial focal adenomyomas or to evacuate cystic haemorrhagic lesions of less than 1.5 cm in diameter. Instead, resectoscopic treatment is indicated in cases of superficial adenomyotic nodules > 1.5 cm in size and for diffuse superficial adenomyosis. Finally, endometrial ablation may be performed with the additional removal of the underlying myometrium.

scholarly journals Hysteroscopy in evaluation of intrauterine causes of abnormal uterine bleeding

2020 ◽  
Vol 8 (10) ◽  
pp. 3694
Author(s):  
Nikita Gandotra ◽  
Isha Sunil ◽  
Shazia Zargar
Keyword(s):  
Medical Records ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histopathological Diagnosis ◽  
Cervical Canal ◽  
Common Symptom ◽  
Age Group ◽  
Easy Method ◽  
Obstetrics And Gynaecology

Background: Various endometrial pathologies contribute to a large proportion of cases of abnormal uterine bleeding (AUB) during the reproductive years as well as after menopause.Methods: This is a retrospective observational study conducted in department of Obstetrics and Gynaecology at SMGS Hospital, Jammu. 200 patients between 20-70 years age presenting to gynaecology OPD with abnormal uterine bleeding between January 2019 to December 2019 were studied. All patients were subjected to thorough clinical evaluation followed by hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB were studied. Hysteroscopy directed biopsies were taken in the same sitting and sent for histopathology and culture. Results: Mean age of patients in our study was 45 years with majority of patients in 40-50-year age group (69%). Most common symptom reported was menorrhagia (48%) followed by menometrorrhagia (18%) and polymenorrhea (10%). Hysteroscopy detected intrauterine abnormality in 59% cases. Most common being hyperplastic endometrium in 52 patients (26%) followed by polyp (20%). 14 (7%) had sub mucous fibroid, 8 (4%) had atrophic endometrium and 2 (1%) had intrauterine adhesions.Conclusion: Hysteroscopy provides a simple & easy method for visualization of the cervical canal & uterine cavity for the evaluation of AUB. Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.

scholarly journals Hysteroscopic assessment of patients with abnormal uterine bleeding: a prospective study at a tertiary care hospital

2017 ◽  
Vol 6 (4) ◽  
pp. 1326
Author(s):  
S.V. Nachiketha
Keyword(s):  
Tertiary Care ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Highly Sensitive ◽  
Chief Complaints ◽  
One Year ◽  
A Prospective Study

Background: Hysteroscopy has been found useful to evaluate the problem of abnormal uterine bleeding. It helps to resolve this by direct view of uterus. It is useful in detecting endometrial hyperplasia. Objective of the study is to evaluate the role of Hysteroscopy in the diagnosis of patients with AUB and Correlate HPR findings.Methods: Total 50 woman who presented with complaints of abnormal uterine bleeding were studied for one year from December 2012 to November 2013. The observations obtained were analyzed.Results: Total of 50 women presenting with complaints of abnormal uterine bleeding were enrolled. Data obtained analyzed and final results and observations were tabulated pertaining to age, Chief complaints, Duration of symptoms, Menopause, Parity, Hysteroscopic/HPR findings, Accuracy obtained correlating with HPR.Conclusions: Hysteroscopy is highly sensitive diagnostic procedure which not only provides useful information of the uterine cavity but also an ideal method for the evaluation of patients with abnormal uterine bleeding.

scholarly journals Pseudo Vaginoscopy: A Modified Vaginoscopy Technique for Outpatient Hysteroscopy in Cases with Difficult Access

2021 ◽  
pp. 131-136
Author(s):  
Fouzia Rasool Memon ◽  
Nusrat Fozia Pathan ◽  
Asma Naz ◽  
Hazooran Lakhan ◽  
Shahida Baloch ◽  
...  
Keyword(s):  
Selection Criteria ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
General Anaesthetic ◽  
Outpatient Hysteroscopy ◽  
Cost Effective Alternative ◽  
Cervical Preparation ◽  
One Year ◽  
A Prospective Study ◽  
Very High

Background: Outpatient hysteroscopy is a safe, reliable and cost-effective alternative to hysteroscopy under a general anaesthetic for the diagnosis of abnormal uterine bleeding. Objectives: The objective of this study was to introduce new technique of pseudo-vaginoscopy for better movement of hysteroscope and less procedural pain. Also to assess acceptability of patients for outpatient hysteroscopy when appropriate analgesia was given prior to the procedure. Methodology: A prospective study was conducted of 74 women attending for outpatient hysteroscopy at the West Cumberland Hospital over a period of one year. Selection criteria include very narrow and atrophic vagina and failed speculum examination in gynaecology outpatient clinics. Results: Of the women studied, 95.5% stated that they would recommend the procedure to friends in future, whilst 5.8% would not want to go through it again. The type of anaesthetic administered during the procedure seem to influence whether women would attend for outpatient hysteroscopy in future. Conclusion: Our pseudo-vaginoscopic approach allows more freedom for the scope movements not limited by the speculum with the advantage of prior cervical preparation.  It was certainly at value for operative outpatient hysteroscopy in patients with very high BMI where access was difficult owing to depth.

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