Assessment of Postmenopausal Bleeding Using Diagnostic Hysteroscopy

Open Access

Abstract

Background: Postmenopausal bleeding (PMB) is an alarming symptom because it may indicate underlying endometrial pathology, including endometrial carcinoma. Diagnostic hysteroscopy allows direct visualization of the uterine cavity and targeted biopsy. Methods & Materials: This cross-sectional observational study was conducted in the Department of Gynecological Oncology at Bangabandhu Sheikh Mujib Medical University from November 2021 to October 2022. A total of 50 women with PMB attending inpatient and outpatient departments were selected by purposive sampling. All patients underwent clinical evaluation, transvaginal sonography (TVS), diagnostic hysteroscopy and histopathological examination (HPE). Hysteroscopic findings were compared with histopathological diagnosis. Results: Most patients (36.0%) were aged 51-55 years and 76.0% were housewives. Hypertension and diabetes mellitus were present in 40.0% and 30.0% of patients, respectively. TVS showed thickened endometrium in 46.0% cases. On hysteroscopy, endometrial hyperplasia was the most common finding (28.0%), followed by atrophic endometrium (26.0%) and endometrial polyp (20.0%). Histopathology also revealed endometrial hyperplasia as the predominant diagnosis (26.0%). Concordance between hysteroscopy and histopathology was 92.8% for endometrial hyperplasia, 92.3% for atrophic endometrium, 90.0% for endometrial polyp, 100% for submucous fibroid and 85.7% for endometrial carcinoma. Conclusion: Diagnostic hysteroscopy showed a good correlation with histopathological findings in evaluating PMB. It is a valuable tool for detecting focal intrauterine lesions and guiding appropriate management.