Publication:

Diagnostic hysteroscopy in abnormal uterine bleeding: a five years study in Kathmandu university hospital

Background Abnormal uterine bleeding is the cause of concern, inconvenience and discomfort to many ladies, this affects millions of women in both developed and developing world.  Until recent times, dilatation and curettage was the usual method of evaluation .This detects the cause of bleeding in less than 50% of the cases, but hysteroscopy is a better diagnostic modality and prompt treatment can be provided in the same setting.

Methods A prospective study was carried out in the Department of Obstetrics and Gynecology at Dhulikhel hospital, Kathmandu University Hospital, Kavre, Nepal from January 2010 to January 2016. Two hundred and eighteen cases were enrolled in this study. Patients with abnormal uterine bleeding above the age of 18 years were enrolled. Hysteroscopic examination was done in all patients after the pregnancy was ruled out with urine pregnancy test and ultrasonology. The patients then underwent hysteroscopic guided endometrial sampling and endometrium was sent for histopathologic examination. The correlation between findings on hysteroscopy and histopathologic examination was tabulated.

Results Following were the findings on hysteroscopy: proliferative endometrium was in 59%, secretary   endometrium was in 14%,endometrial hyperplasia in 12%, atrophic in 2 %, endometrial polyp in 7%, submucous myoma in  5% and carcinoma of endometrium in 1%.

Conclusions In patients with abnormal uterine bleeding, hysteroscopy provides more accurate diagnosis than dilatation and curettage.