Akademik Veri Yönetim Sistemi
Jinekoloji ve Obstetrik Dergisi, cilt.18, sa.2, ss.74-81, 2004 (Scopus, TRDizin)
OBJECTIVE: The hysteroscopic procedures in our clinic were retrospectively reviewed in order to reveal the diagnostic accuracy and the efficacy of various tests such as transvaginal ultrasonography (TVUSG), saline infusion sonography (SIS), and hysteroscopy in the management of abnormal uterine bleeding and infertility. STUDY DESIGN: The study was completed in Istanbul University Cerrahpasa School of Medicine, Department of Obstetrics and Gynecology, by reviewing the medical records of the patients underwent hysteroscopy between 1.1.1997 and 31.12.2002. The record of 385 patients were reviewed. Their names, ages, menopausal status, obstetric and medical history, complaints, the characteristics of hysterosalpingography, saline infusion sonography and hysteroscopy and the results of the histopathological examinations were noted. The sensitivity, specificity, positive and negative predictive values for saline infusion sonography and hysteroscopy were calculated for each histopathological diagnosis. RESULT(s): The mean age of the patients was 38±10 years. Three hundred and twenty-one patients were pre-menopausal and 64 were postmenopausal. The major indications were endometrial polyps (215 cases, 55%), infertility (89 cases, 23%) and submucous fibroids (33 cases, 9%). The histopathological examination of the specimens obtained during hysteroscopic procedures revealed endometrial polyps in 168 cases (43.5%) and reported as normal in 108 cases (28%). The sensitivity and specificity of hysteroscopy for detecting endometrial polyps were 83% and 63%, respectively. False negative rate was 16% and false positive rate was 36%. The sensitivity and specificity of saline infusion sonography for detecting endometrial polyps were 86% and 28%, respectively. False negative rate was 12% and false positive rate was 71%. The sensitivity and specificity of hysteroscopy for detecting submucous fibroids were 80% and 91%, respectively. False negative rate was 20% and false positive rate was 9.8%. The sensitivity and specificity of saline infusion sonography for detecting submucous fibroids were 76% and 92%, respectively. False negative rate was 23% and false positive rate was 7%. No peroperative complication was observed in 97% of the cases. Nine of the complications occurred in the pre-menopausal whereas two in the postmenopausal patients. Uterine perforation was detected in four cases; intrauterine cavity could not be entered in three of the cases. Cervical laceration in a case and death was noted in another case. In postmenopausal patients, one uterine perforation and one inability to enter the uterine cavity was noted. CONCLUSION(s): Due to its high diagnostic accuracy and lower complication rate, we believe that hysteroscopy will retain its place as the gold-standard procedure for investigating endometrial pathologies.