Prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding

Lasmar, Ricardo Bassil; Dias, Rogério; Barrozo, Paulo Roberto Mussel; Oliveira, Marco Aurélio Pinho; da Silva Freire Coutinho, Evandro; da Rosa, Daniela Baltar

doi:10.1016/j.fertnstert.2007.05.045

« Previous Next »Fertility and Sterility
Volume 89, Issue 6 , Pages 1803-1807, June 2008

Prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding

Ricardo Bassil Lasmar, Ph.D.
- Department of Gynecology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Gynecological Endoscopy Service, Botucatu School of Medicine, São Paulo, Brazil
- Post-graduate Program in Gynecology, Obstetrics and Mastology, São Paulo State University (UNESP), São Paulo, Brazil
- Ginendo Endoscopy Center, Rio de Janeiro, Brazil
- Reprint requests: Ricardo Bassil Lasmar, Ph.D., Rua Voluntários da Pátria 126, sala 602, Botafogo, Rio de Janeiro, Brazil 22270-010 (FAX: 55-21-25372321).
Rogério Dias, Ph.D.
- Gynecological Endoscopy Service, Botucatu School of Medicine, São Paulo, Brazil
- Post-graduate Program in Gynecology, Obstetrics and Mastology, São Paulo State University (UNESP), São Paulo, Brazil
Paulo Roberto Mussel Barrozo, M.D.
- Post-graduate Program in Gynecology, Obstetrics and Mastology, São Paulo State University (UNESP), São Paulo, Brazil
- Ginendo Endoscopy Center, Rio de Janeiro, Brazil
Marco Aurélio Pinho Oliveira, Ph.D.
- Department of Gynecology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
Evandro da Silva Freire Coutinho, Ph.D.
- Department of Epidemiology and Quantitative Methods in Health Care, National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
Daniela Baltar da Rosa, M.D.
- Post-graduate Program in Gynecology, Obstetrics and Mastology, São Paulo State University (UNESP), São Paulo, Brazil
- Ginendo Endoscopy Center, Rio de Janeiro, Brazil

Received 13 February 2007; received in revised form 17 May 2007; accepted 23 May 2007. published online 24 September 2007.

Objective

To describe the prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding (AUB).

Design

Retrospective series of consecutive patients.

Setting

Tertiary care university hospital and private office.

Patient(s)

Four thousand fifty-four hysteroscopies with biopsy in patients with AUB evaluated between June 1993 and December 2004.

Intervention(s)

Hysteroscopies were performed using 2.9-mm or 4-mm telescopes with CO₂ or saline as the distension media. Biopsies were done with a 5-mm grasper or with a Novak's curette.

Main Outcome Measure(s)

Prevalence of hysteroscopic findings and histologic analysis of biopsies.

Result(s)

Endometrial polyp was the most frequent hysteroscopic finding, accounting for 1,374 (33.9%) cases. Normal uterine cavity and cervical canal were found in 814 (20.1%) patients. Submucous fibroids were diagnosed in 302 (7.5%) women. Normal endometrium was the most frequent histologic diagnosis, accounting for 1,888 (46.6%) cases. Endometrial polyp was found in 1,115 (27.5%) patients. Endometrial hyperplasia was diagnosed in 613 (15.1%) and endometrial cancer in 105 (2.6%) women.

Conclusion(s)

Endometrial polyps are the most frequent hysteroscopic findings in patients with AUB, whereas normal endometrium is the most frequent histologic diagnosis.

Key Words: Abnormal uterine bleeding, hysteroscopy, endometrial polyps, histopathology, prevalence