Retrospective Analysis of Hysteroscopic and Histopathologic Diagnosis in Egyptian Women Presented with Abnormal Uterine Bleeding

Abstract

Abnormal uterine bleeding is a major gynecological problem, accounting for 33% of outpatient referrals, including 69% of referrals in perimenopausal, and postmenopausal age group. Evaluation of abnormal uterine bleeding is of critical importance to confirm the benign nature of the problem, and to exclude endometrial carcinoma. Hysteroscopy is known as the gold standard procedure for uterine cavity assessment. All cases which presented with abnormal uterine bleeding and underwent hysteroscopy during the period from January 2007 to December 2012 at Early Cancer Detection Unit, Maternity Hospital, Ain Shams Univeristy were collected. The hysteroscopic findings of the patients and their clinical data as age, gynecological and obstetric history were collected from their charts, and the histopathological diagnoses were obtained from archives. After exclusion, 682 cases were included in this study. Our results showed that, the age of involved patients was ranged between 23 and 85 years with a mean 46.5+9.63 years. The most common age group was from 41 to 50 years (47.1%) followed by the age group from 51 to 85 (28.9%). Hysteroscopic examination revealed that 37% of cases were endometrial hyperplasia (thick endometrium), 19.8% were endometrial polyp, 13.9% were leiomyoma, 8.1%were atrophic (thin) endometrium, 3.8%were abnormal polypoid tissue, 2.2% were congested endometrium, and 15.2%were endometrium with no gross pathology. Histopathological examination revealed that, 26.2% were endometrial polyp, 16.2% were endometrial hyperplasia, 12.2%were leiomyoma, 10.1% were chronic non-specific endometritis, 7.6% were endometrium under progesterone effect, 6.3% were disordered proliferative endometrium, 5.4% were uterine malignancy, 4% were crumbled endometrium, 2.8% were atrophic endometrium, 5% were secretory endometrium, and 4% were proliferative endometrium.