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Original Research

Open Access

Accuracy and diagnostic value of outpatient hysteroscopy for malign and benign disease

  • T. Issat1,2
  • J. Beta1,2
  • M.A. Nowicka1
  • A.J. Jakimiuk1,2,*,

1Department of Obstetrics, Women’s Diseases and Oncogynecology, Central Clinical Hospital of Ministry of Interior and Administration, Warsaw

2Center for Reproductive Health, Institute of Mother and Child’s Health, Warsaw (Poland)

DOI: 10.12892/ejgo23692014 Vol.35,Issue 1,January 2014 pp.52-55

Published: 10 January 2014

*Corresponding Author(s): A.J. Jakimiuk E-mail: jakimiuk@yahoo.com

Abstract

Background: The aim of the study was to evaluate accuracy of the outpatient hysteroscopy. Materials and Methods: This was a retrospective cohort study of 494 women who underwent outpatient hysteroscopy after administration of non-steroidal anti-inflammatory agents with the 3.2 mm hysteroscope. Normal saline solution was used as the distension medium. All women were discharged in good general condition afterwards. Results: In cases of abnormal uterine bleeding, there was no apparent pathology found in 112 cases (83.6%). Detection rate (DR) of endometrial polyps was 88.7% with false positive rate (FPR) of 4.6%. Positive predictive value (PPV) was 82.7% with negative predictive value (NPV) of 93.1%. Detection rate (DR) of the submucosal fibroids was 57.7%. Positive predictive value (PPV) was 57.7% with negative predictive value (NPV) of 95.0%. Endometrial cancer was confirmed in ten cases (2.0%), being suspected in eight cases during the procedure. DR in case of the endometrial cancer was 80.0% with FPR of 0.4%. PPV was 66.7% with NPV) of 99.6%. Conclusions: Outpatient hysteroscopy seems to be an effective and accurate diagnostic tool.


Keywords

Office hysteroscopy; Outpatient hysteroscopy; Hysteroscopy.


Cite and Share

T. Issat,J. Beta,M.A. Nowicka,A.J. Jakimiuk. Accuracy and diagnostic value of outpatient hysteroscopy for malign and benign disease. European Journal of Gynaecological Oncology. 2014. 35(1);52-55.

References

[1] Cicinelli E., Tinelli R., Loiudice L., Loiudice I., Quattromini P., Fusco A., et al.: “AlphaScope vs lens-based hysteroscope for office polypectomy without anesthesia: randomized controlled study“. J. Minim. Invasive Gynecol., 2011, 18, 796.

[2] Clark T.J.,Voit D., Gupta J.K., Hyde C, Song F., Khan KS.: “Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systematic quantitative review“. JAMA, 2002, 288, 1610.

[3] Farquhar C., Ekeroma A., Furness S., Arroll B.: “A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women“. Acta Obstet. Gynecol. Scand., 2003, 82, 493.

[4] van Dongen H., de Kroon C.D., Jacobi C.E., Trimbos J.B., Jansen F. W.: “Diagnostic hysteroscopy in abnormal uterine bleeding: a sys-tematic review and meta-analysis“. BJOG, 2007, 114, 664.

[5] Marsh F.A., Rogerson L.J., Duffy S.R. “A randomised controlled trial comparing outpatient versus day case endometrial polypectomy“. BJOG, 2006, 113, 896.

[6] Clark T.J., Mahajan D., Sunder P., Gupta J.K.: “Hysteroscopic treatment of symptomatic submucous fibroids using a bipolar intrauterine system: a feasibility study“. Eur. J. Obstet. Gynecol. Reprod. Biol., 2002, 100, 237.

[7] Prasad P., Powell M.C.: “Prospective observational study of Thermablate Endometrial Ablation System as an outpatient procedure“. J. Minim. Invasive Gynecol., 2008, 15, 476.

[8] Sinha D., Kalathy V., Gupta J.K., Clark T.J.: “The feasibility, success and patient satisfaction associated with outpatient hysteroscopic sterilisation“. BJOG, 2007, 114, 676.

[9] Lau W.C., Ho R.Y., Tsang M.K., Yuen P.M.: “Patient’s acceptance of outpatient hysteroscopy“. Gynecol. Obstet. Invest., 1999, 47, 191.

[10] RCOG Green-top Guideline No. 59 Best Practice in Outpatient Hysteroscopy?

[11] Mencaglia L., Perino A., Hamou J.: “Hysteroscopy in perimenopausal and postmenopausal women with abnormal uterine bleeding“. J. Reprod. Med., 1987, 32, 577.

[12] Emanuel M.H., Verdel M.J., Wamsteker K., Lammes FB.: “A prospective comparison of transvaginal ultrasonography and diagnostic hysteroscopy in the evaluation of patients with abnormal uterine bleeding: clinical implications“. Am. J. Obstet. Gynecol., 1995, 172, 547.

[13] Metzger U., Bernard J.P., Camatte S., Lelièvre L., Robin F., Lefrère-Belda M.A, Lécuru F. Sono-guided endometrial biopsy: comparison with hysteroscopy biopsy. Sono-guided endometrial biopsy using the Bernard catheter had no impact on endometrial assessment by sonohysterography“. Gynecol. Obstet. Invest., 2004, 58, 26. Epub 2004 Mar 18.

[14] Kelekci S., Kaya E., Alan M., Alan Y., Bilge U., Mollamahmutoglu L.: “Comparison of transvaginal sonography, saline infusion sonography, and office hysteroscopy in reproductive-aged women with or without abnormal uterine bleeding“. Fertil. Steril., 2005, 84, 682.

[15] Fong K., Kung R., Lytwyn A., Trudeau M., Chapman W., Nugent P., et al.: “Endometrial evaluation with transvaginal US and hysterosonography in asymptomatic postmenopausal women with breast cancer receiving tamoxifen“. Radiology, 2001, 220, 765.

[16] Dijkhuizen F.P., Brölmann H.A., Roumen R.M., Bastin F.H., Heintz A. P.: “Increase in risk of endometrial carcinoma following treatment of breast carcinoma with tamoxifen“. Ned. Tijdschr. Geneeskd., 1995, 139, 2393.

[17] Parsons A.K., Lense J.J.: “Sonohysterography for endometrial abnormalities: preliminary results“. J. Clin. Ultrasound, 1993, 21, 87.

[18] Dijkhuizen F.P., De Vries L.D., Mol B.W., Brölmann H.A., Peters H. M., Moret E., Heintz A.P.: “Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women“. Ultrasound Obstet. Gynecol., 2000, 15, 372.

[19] Williams C.D., Marshburn P.B.: “A prospective study of transvaginal hydrosonography in the evaluation of abnormal uterine bleeding“. Am. J. Obstet. Gynecol., 1998, 179, 292.

[20] Gull B., Karlsson B., Milsom I., Granberg S.: “Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer“. Am. J. Obstet. Gynecol., 2003, 188, 401.

[21] Maia H. Jr., Barbosa I.C., Farias J.P., Ladipo O.A., Coutinho E.M.: “Evaluation of the endometrial cavity during menopause“. Int. J. Gynaecol. Obstet., 1996, 52, 61.

[22] Smith-Bindman R., Kerlikowske K., Feldstein V.A., Subak L., Scheidler J., Segal M., et al. Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities. JAMA, 1998, 280, 1510.

[23] Clark T.J., Voit D., Gupta J.K., Hyde C., Song F., Khan K.S.: “Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systematic quantitative review“. JAMA, 2002, 288, 1610.

[24] Gimpelson R.J.: “Panoramic hysteroscopy with directed biopsies vs. dilatation and curettage for accurate diagnosis“. J. Reprod. Med., 1984, 29, 575.

[25] Gimpelson R.J., Rappold H.O.: “A comparative study between panoramic hysteroscopy with directed biopsies and dilatation and curettage. A review of 276 cases“. Am. J. Obstet. Gynecol., 1988, 158, 489.

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