Diagnostic hysteroscopy: a valuable diagnostic tool in the diagnosis of structural intra-cavital pathology and endometrial hyperplasia or carcinoma?. Six years of experience with non-clinical diagnostic hysteroscopy.
OBJECTIVE
1045 diagnostic hysteroscopic procedures performed throughout six consecutive years were evaluated, focussing on its value in diagnosing endometrial hyperplasia and carcinoma.


METHODS
Retrospective study performed in the gynaecological endoscopy clinic of a training hospital. Subjects were 1045 pre- and post-menopausal patients.


RESULTS
A normal cavity was found in 54.2%. Most common abnormal findings were fibroids (21.0%) and endometrial polyps (14.4%). Hysteroscopically diagnosed hyperplasia of the endometrium was confirmed histologically in only less than half the cases. Endometrial carcinoma was suspected on hysteroscopic view in two cases of a total of seven proven cases. In three cases initially an endometrial polyp and in two cases a fibroid was diagnosed. Once the diagnosis was missed even after biopsy taking.


CONCLUSIONS
Diagnostic hysteroscopy is a valuable diagnostic tool in diagnosing structural intra-cavital pathology, very suitable for the outpatient clinic. The value in diagnosing hyperplasia or endometrial carcinoma is limited and even after guided biopsy a malignancy cannot be ruled out.
de Wit
Alexander C
AC
Department of Obstetrics and Gynaecology, Rivierenland Hospital President Kennedylaan 1, 4002 WP, Tiel, The Netherlands.
Vleugels
Michel P H
MP
de Kruif
Jan H
JH
D001706:Biopsy; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000002:abnormalities; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007889:Leiomyoma / Q000175:diagnosis; D011127:Polyps / Q000175:diagnosis; D017698:Postmenopause; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage; D014594:Uterine Neoplasms / Q000175:diagnosis