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Hysteroscopy in postmenopausal bleeding.

Tandulwadkar S, Deshmukh P, Lodha P, Agarwal B - J Gynecol Endosc Surg (2009)

Bottom Line: Department of Obstetrics and Gynecology of Ruby Hall Clinic, Pune.Sixty postmenopausal women with complaint of bleeding per vaginum.Hysteroscopic images were analyzed and compared with histopathologic results.

View Article: PubMed Central - PubMed

Affiliation: Ruby Hall IVF & Endoscopy Center, Ruby Hall Clinic, Pune, India.

ABSTRACT

Objectives: 1) To study the etiology of postmenopausal bleeding (PMB). 2) To study the significance of hysteroscopy in evaluation of the etiopathogenic factors. 3) Correlating the diagnosis after transvaginal sonography (TVS), hysteroscopy and histopathologic diagnosis. 4) Feasibility of conservative management with hysteroscopy in PMB.

Design: Prospective study from January 2008 to June 2009.

Setting: Department of Obstetrics and Gynecology of Ruby Hall Clinic, Pune.

Patients: Sixty postmenopausal women with complaint of bleeding per vaginum.

Interventions: Clinical and sonographic evaluation, followed by diagnostic and/or therapeutic hysteroscopy and guided biopsy. Hysteroscopic images were analyzed and compared with histopathologic results.

Measurements and main results: On hysteroscopy, endometrium was classified as suggestive of normal, atrophic, endometrial hyperplasia or endometrial carcinoma. Histopathologic diagnosis is taken as a gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. The sensitivity and specificity of hysteroscopy in diagnosing endometrial pathologies was assessed.

Conclusions: In women with PMB, hysteroscopy is the basic tool that allows precise diagnosis of various endouterine pathologies. The average sensitivity of hysteroscopy was 97% in our study and the specificity was 98.66%. Hence, we can conclude that it is highly accurate for evaluating endometrial pathologies. For obvious benign lesions, it also provides treatment in the same sitting, therefore avoiding an extensive, morbid, and expensive procedure like hysterectomy.

No MeSH data available.


Related in: MedlinePlus

Multiple Endometrial Polyps
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Figure 0003: Multiple Endometrial Polyps

Mentions: It is apparent that hysteroscopy is much more sensitive than TVS in the detection of focal endometrial pathologies such as endometrial polyp [Figure 3] (97 and 76.7%, respectively). Rather, the technical improvements have made hysteroscopy most suitable for office use. Also the specificity of hysteroscopy is more than TVS in diagnosing various endometrial conditions (98.5 and 93.3%, respectively) [Table 9].


Hysteroscopy in postmenopausal bleeding.

Tandulwadkar S, Deshmukh P, Lodha P, Agarwal B - J Gynecol Endosc Surg (2009)

Multiple Endometrial Polyps
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3304274&req=5

Figure 0003: Multiple Endometrial Polyps
Mentions: It is apparent that hysteroscopy is much more sensitive than TVS in the detection of focal endometrial pathologies such as endometrial polyp [Figure 3] (97 and 76.7%, respectively). Rather, the technical improvements have made hysteroscopy most suitable for office use. Also the specificity of hysteroscopy is more than TVS in diagnosing various endometrial conditions (98.5 and 93.3%, respectively) [Table 9].

Bottom Line: Department of Obstetrics and Gynecology of Ruby Hall Clinic, Pune.Sixty postmenopausal women with complaint of bleeding per vaginum.Hysteroscopic images were analyzed and compared with histopathologic results.

View Article: PubMed Central - PubMed

Affiliation: Ruby Hall IVF & Endoscopy Center, Ruby Hall Clinic, Pune, India.

ABSTRACT

Objectives: 1) To study the etiology of postmenopausal bleeding (PMB). 2) To study the significance of hysteroscopy in evaluation of the etiopathogenic factors. 3) Correlating the diagnosis after transvaginal sonography (TVS), hysteroscopy and histopathologic diagnosis. 4) Feasibility of conservative management with hysteroscopy in PMB.

Design: Prospective study from January 2008 to June 2009.

Setting: Department of Obstetrics and Gynecology of Ruby Hall Clinic, Pune.

Patients: Sixty postmenopausal women with complaint of bleeding per vaginum.

Interventions: Clinical and sonographic evaluation, followed by diagnostic and/or therapeutic hysteroscopy and guided biopsy. Hysteroscopic images were analyzed and compared with histopathologic results.

Measurements and main results: On hysteroscopy, endometrium was classified as suggestive of normal, atrophic, endometrial hyperplasia or endometrial carcinoma. Histopathologic diagnosis is taken as a gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. The sensitivity and specificity of hysteroscopy in diagnosing endometrial pathologies was assessed.

Conclusions: In women with PMB, hysteroscopy is the basic tool that allows precise diagnosis of various endouterine pathologies. The average sensitivity of hysteroscopy was 97% in our study and the specificity was 98.66%. Hence, we can conclude that it is highly accurate for evaluating endometrial pathologies. For obvious benign lesions, it also provides treatment in the same sitting, therefore avoiding an extensive, morbid, and expensive procedure like hysterectomy.

No MeSH data available.


Related in: MedlinePlus