Accuracy of Hysteroscopic Endomyometrial Biopsy in Diagnosis of Adenomyosis

Dakhly DM, Dina M R Dakhly, Abdel Moety GA, Ghada Abdel Fattah Abdel Moety, Ghada A F Abdel Moety, Saber W, Waleed Saber, Gad Allah SH, Sherine H. Gad Allah, Ahmed T. Hashem, Hashem AT, Abdel Salam LO, Lubna O E Abdel Salam, Lubna Omar El-Farouk Abdel Salam
Journal of Minimally Invasive Gynecology · 2015 · vol. 23(3) , pp. 364–371 · doi:10.1016/j.jmig.2015.11.004 · PMID:26581187 · W2174922077
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This study assessed the accuracy of hysteroscopic endomyometrial biopsy in diagnosing adenomyosis compared to histopathological examination of hysterectomy specimens.

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Abstract

ObjectivesTo investigate the diagnostic accuracy of endomyometrial biopsy obtained via office hysteroscopy for the diagnosis of adenomyosis.Study designCross-sectional study.SettingCairo University Teaching Hospital, Cairo, Egypt.PatientsA total of 404 premenopausal women with symptoms clinically suggestive of having adenomyosis.InterventionsAll patients were subjected to 2-dimensional transvaginal sonography (TVS) in-office hysteroscopy examination with endomyometrial biopsy. Patients who subsequently underwent hysterectomy were included in the final analysis.Main measurements and resultsAccuracy of diagnostic modalities was represented using the terms sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy. A total of 292 patients were eligible for final analysis. Of these, 162 (55.47%) were diagnosed with adenomyosis based on hysterectomy specimens. TVS had a high sensitivity (83.95%) and a moderate specificity (60%). In contrast, endomyometrial biopsy was more specific (78.46%) than sensitive (54.32%). Hysteroscopic appearance of the endometrial cavity had low sensitivity (40.74%) and specificity (44.62%). Adding endomyometrial biopsy to TVS improved specificity (89.23%).ConclusionEndomyometrial biopsy obtained via office hysteroscopy can diagnose adenomyosis with a high specificity and is recommended after TVS.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Ambulatory Surgical Procedures Endometrium Hysterectomy Hysteroscopy Hysteroscopy Vagina Adenomyosis Adenomyosis Adenomyosis Adult Cross-Sectional Studies Egypt Endometrium Endometrium Female Humans Hysterectomy Premenopause Referral and Consultation

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