Hysteroscopy as a diagnostic aid in gynecology

Abstract

Endoscopic techniques for diagnosis and treatment of several diseases have gained importance in medicine, especially over recent years. The advantage lies in direct optical judgment of body cavities and frequently the possibility of surgical treatment during same procedure.Although diagnostic and operative laparoscopy has been established in gynecology for several decades, hysteroscopy is still neglected due to problematic nature of its technical developments. This study was conducted at Govt.Medical College,Miraj from November 2011 to October 2013, highlights the role of hysteroscopy as a diagnostic tool in gynecology.The aim of this study was to evaluate the diagnostic role of hysteroscopy in abnormal uterine bleeding and infertility. This was a prospective study carried out in Department of Obstetrics and Gynecology after approval of ethical committee. Outdoor and indoor patients with complaints of abnormal uterine bleeding and infertility underwent hysteroscopy followed by directed biopsy of endometrium for histopathological study. It was found that 50 patients were of age group from 20-70 years and most common age group was 40-49 years (50%). Most common presenting symptom was Menorrhagia(60%). 51.02% had abnormal findings on hysteroscopy while 48.98% had normal intra-uterine cavity. Most common lesion detected was Endometrial hyperplasia in 40% patients followed by endometrial polyp (32%), atrophic endometrium(12%), submucous fibroid(8%), intrauterine synechiae(4%) and CuT embedded in fundal region(4%). Sensitivity, specificity, PPV, NPV and accuracy of diagnostic hysteroscopy was 95.65%, 88.46%, 88%, 95.83% and 91.84%respectively. It was concluded that hysteroscopy is a reliable tool for evaluating the patients of AUB and Infertility and should be followed by endometrial biopsy.