Comparison of hysteroscopic and hysterectomy findings for assessing the diagnostic accuracy of office hysteroscopy.
OBJECTIVE
To assess the diagnostic accuracy of office hysteroscopy by comparing the hysteroscopic findings with the histologic findings on the hysterectomy specimens.


METHODS
Retrospective clinical study.


METHODS
University-affiliated hospital.


METHODS
Review of the hospital records of 443 patients who underwent office hysteroscopy and, within 2 months, hysterectomy.


METHODS
We compared the hysteroscopic findings (including targeted biopsies) with the histologic findings that were obtained after hysterectomy. The results of this study were then compared with those of a previous study in which we examined the diagnostic accuracy of dilatation and curettage (D&C).


METHODS
We evaluated the diagnostic accuracy of office hysteroscopy.


RESULTS
When compared with the histologic diagnosis of the uterus, the hysteroscopic findings showed a diagnostic sensitivity of 98%, a specificity of 95%, a positive predictive value (PPV) of 96%, and a negative predictive value (NPV) of 98%. Hysteroscopy was found to have a greater diagnostic accuracy than D&C: the sensitivity and the NPV of the two diagnostic procedures were statistically different.


CONCLUSIONS
Office hysteroscopy is confirmed as a powerful diagnostic tool, but targeted biopsies, performed with a small diameter operative hysteroscope, must be performed in cases of suspect endometrium to confirm the image-based diagnosis.
Ceci
Oronzo
O
Department of General and Specialist Surgical Sciences, Section of Obstetrics and Gynecology, University of Bari, Italy. ceci-o@libero.it
Bettocchi
Stefano
S
Pellegrino
Annarosa
A
Impedovo
Luigi
L
Di Venere
Raffaella
R
Pansini
Nicola
N
D004107:Dilatation and Curettage / Q000592:standards; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy; D008499:Medical Records; D015203:Reproducibility of Results; D012189:Retrospective Studies