scholarly journals Role of Transvaginal Sonography and Diagnostic Hysteroscopy in Abnormal Uterine Bleeding

Author(s):  
Veena B.T
Author(s):  
Mamatha Shivanagappa ◽  
Vinutha K. Veerabhadrappa ◽  
Madhumitha Mahesh

Background: Dilatation and curettage has long been the diagnostic gold standard for abnormal uterine bleeding. However, even a trained gynecological curettes at best 70-80% of the endometrium. Hysteroscopy is gaining acceptability over other diagnostic technique like dilatation and curettage, hysterosalpingogram and ultrasound. The objective of this study is to find out the role of hysteroscopy in abnormal uterine bleeding and to compare hysteroscopy findings with histopathology.Methods: Fifty patients in perimenopausal age group with abnormal uterine bleeding attending JSS Medical College and Hospital Mysore, during the period 1999-2001 were studied by diagnostic hysteroscopy followed by dilatation and curettage.Results: Mean age of the study group was 44.3% years (±2.5 SD). Menorrhagia was the commonest symptom and was found in 68% of the patients. Diagnostic hysteroscopy identified 23 cases as Normal endometrium, 16 cases as endometrial hyperplasia, 3 cases as atrophic endometrium, 4 cases as endometrial polyp, 4 cases as fibroids. Compared with histopathological findings as definitive diagnosis, hysteroscopy correctly picked up 19 cases of (86.9%), normal endometrium, 12 cases of hyperplasia (75%), 3 cases of atrophic endometrium (100%), 4 cases of polyps (100%), and 4 cases of fibroid (100%).Conclusions: Hysteroscopy should be considered as a basic and essential diagnostic procedure in the diagnostic work up of abnormal uterine bleeding. 


2009 ◽  
Vol 1 (2) ◽  
pp. 98 ◽  
Author(s):  
NeemaS Acharya ◽  
DeeptiS Shrivastava ◽  
SheetalG Patil ◽  
SB Bhute ◽  
SA Inamdar

Author(s):  
Nisha Solanki ◽  
Prashant Suryarao ◽  
Aditi Bhatnagar

Background: Postmenopausal bleeding is defined as permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Incidence of abnormal uterine bleeding is 10% to 15% in postmenopausal bleeding. For evaluation of postmenopausal bleeding earlier dilatation and curettage was considered as gold standard which is a blind procedure, transvaginal sonography has improved the accuracy of endometrial morphology. Now the focus has shifted to hysteroscopic guided biopsy which is gold standard for evaluating postmenopausal bleeding it also has benefit of see and treat modality. The objective of this study was to study the significance of hysteroscopy in diagnosis of etiopathological factors of postmenopausal bleeding. To correlate the diagnosis by TVS, hysteroscopy and histopathological diagnosis.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital from June 2016 to September 2018. A total of 30 cases were evaluated. The commencement of the study was followed by approval of the institutional ethical committee.Results: In our study, 83.34% of patients with postmenopausal bleeding where in age group menopause is >55 years. 66.67% are overweight with BMI of 25-29.9. We evaluated the ET <4 mm, 4-12 mm, >12 mm thickness, 53.33% were between 4-12 mm of ET. In our study endometrial hyperplasia shows 30% in hysteroscopy, on HPE shows 33.33%, in atrophic endometrium 20% on HPE is also 20%, polyp shows 6.67% in both hysteroscopy and HPE, sub mucous myoma on both hysteroscopy and HPE shows 3.33% and Ca endometrium shows 3.33% in both hysteroscopy and HPE.Conclusions: Study of total 30 cases were conducted, by using Bettochi Office hysteroscope (2.9 mm). Sensitivity, specificity, positive predictive value and negative predictive value of hysteroscopy was calculated in each group of patients.


Author(s):  
Neerja Gupta ◽  
Geeta Singh ◽  
Bharti Jain ◽  
Satakshi Garg

Background: Abnormal uterine bleeding (AUB) is one of the most common reasons for women seeking gynaecological advice. The objective of this study was to determine the accuracy of Transvaginal sonography (TVS) and Saline Infusion Sonography (SIS) in evaluation of Abnormal Uterine Bleeding (AUB) and to compare the diagnostic accuracy after hysterectomy.Methods: Prospective, comparative study of TVS and SIS in evaluation of AUB in patients who are being subjected to hysterectomy with uterus of less than 12 weeks.Results: 100 patients were included in the study. 98% were of 30-50 years. Heavy menstrual bleeding was the commonest symptom (52%) and most common finding was fibroid, and Polyp followed by abnormal endometrium. The overall sensitivity and specificity when correlated with operative and HPE were 66% and 88% respectively for TVS and 82% and 95% for SIS respectively. The false positive and false negative rates were more in TVS compared to SIS. Commonest histopathology was intramural fibroid in 42% followed by sub mucus myoma in 21%, polyp 18% and endometrial hyperplasia 10%.Conclusions: SIS is a simple highly sensitive and specific technique to detect intra uterine pathology in the evaluation of AUB when TVS findings are inconclusive.


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