Hysteroscopic evaluation in patients with AUB and its correlation with histopathology

Abnormal uterine bleeding (AUB) is characterized by irregularities in menstrual cycles, encompassing variations in frequency, duration, or volume of bleeding during or between periods. This condition significantly affects women's health, impacting 14-25% of reproductive-age women and up to 50% of perimenopausal women. The aim of a recent study was to establish a link between histopathological and hysteroscopic endometrial findings of women with AUB. 

This analytical observational study was undertaken in the Department of Obstetrics and Gynecology and spanned 18 months – involving 63 women aged 35 or above experiencing AUB. Ethical approval was obtained, and participants provided written consent. Comprehensive medical examinations, transvaginal sonography, diagnostic hysteroscopy, and endometrial biopsy were performed.

The results indicated a 90.48% diagnostic accuracy, with a statistically significant correlation between histopathological and hysteroscopic endometrial findings. Hysteroscopy was deemed valuable for identifying AUB causes, but its role was emphasized as a complement, not a substitute for tissue diagnosis––the gold standard. Appropriate management considers age, fertility goals, and histopathological results.

Therefore, hysteroscopy, while offering direct visualization of uterine abnormalities, should not replace essential diagnostic procedures like tissue biopsy, ultrasound, or blood tests. It serves as a supplementary method, providing additional information to enhance the diagnosis and treatment of AUB.

Source: Twinkle, Khan A, Nigar A, Singh K, Gupta B, Khan MFF. Indian J Obstet Gynecol Res. 2023;10(4):426-432