Hysteroscopic myometrial biopsy in unexplained abnormal uterine bleeding

A M Darwish, Atef Darwish, Darwish AM, Makhlouf AM, Ahmed Makhlouf, A M Makhlouf, Youssof AA, A A Youssof, Gadalla HA, H A Gadalla
European journal of obstetrics, gynecology, and reproductive biology · 1999 · vol. 86(2) , pp. 139–143 · doi:10.1016/s0301-2115(99)00062-7 · PMID:10509781 · W1995736594
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Hysteroscopic myometrial biopsy was performed in women with unexplained abnormal uterine bleeding to identify potential underlying causes.

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Abstract

ObjectivesTo define the value of hysteroscopic myometrial biopsy in unexplained abnormal uterine bleeding not responding to hormonal treatment and to compare two hysteroscopic biopsy techniques.DesignA prospective cross-sectional comparative study.SettingGynecologic Endoscopy Unit, Assiut University Hospital, Egypt.PatientsIt comprised 99 patients with abnormal uterine bleeding who underwent transvaginal ultrasonography, endometrial biopsy and diagnostic hysteroscopy, which revealed no local lesions.InterventionsOperative hysteroscopy was performed for 62 of them (group A). Hysteroscopic myometrial biopsies were taken using rigid biopsy forceps and the resectoscope successively guided by the previous ultrasonography of the myometrium. Thirty-seven patients (group B) underwent total abdominal hysterectomy followed by multiple full-thickness myometrial biopsies of the specimens.ResultsPathologic myometrium was diagnosed in 12 (19%), 27 (43%) and 21 (56.5%) biopsies taken with the rigid biopsy forceps and the resectoscope (group A) and full-thickness biopsies (group B) respectively. Thirty biopsies (48%) taken with the rigid biopsy forceps were inadequate for proper histopathologic assessment while thermal effect was excessive in only four biopsies (6%) taken with the resectoscope. Honeycomb sonographic appearance was specific in prediction of adenomyosis.ConclusionsResectoscopic myometrial biopsy can explain the cause of persistent abnormal uterine bleeding in about 43% of cases. Myometrial biopsy using the rigid biopsy forceps is inadequate and is not recommended.

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Condition tags

endometriosis

MeSH descriptors

Biopsy Hysteroscopy Myometrium Myometrium Uterine Hemorrhage Adult Cross-Sectional Studies Endometriosis Endometriosis Endometriosis Evaluation Studies as Topic Female Gynecologic Surgical Procedures Humans Inflammation Inflammation Inflammation Leiomyoma Leiomyoma Leiomyoma

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