The Role of Office Hysteroscopy in The Diagnosis of Uterine Pathology in Cases with Perimenopausal Bleeding

Background: Perimenopausal bleeding refers to any bleeding from the vaginal tract that deviates from the typical frequency, cyclicity, duration, and quantity of flow, occurring at or above the age of Forty.Aim: The current study aimed to examine how individuals who attended an outpatient gynecologic clinic with perimenopausal hemorrhage responded to office hysteroscopy.Patient and Methods: This prospective research was performed on 80 females had perimenopausal hemorrhage who had endometrial biopsy and office hysteroscopy, at Damanhour Medical National Institute from August 2023 till January 2024.Results: According to bleeding pattern, 26 women (32.5%) had menorrhagia, 19 women (23.8%) had metrorrhagia, 22 women (27.5%) had menometrorrhagia, 13 women (16.2%) had polymenorrhoea.According to sonographic analysis, endometrial thickness ranged from (8-25) mm with a mean±SD (13.2±2.9)mm.In 51 women (63.8%) who had a hysteroscopy, the thickness of endometrium was normal; in 49 females (36.2%), it was dense.66 females (82.5%) had no hysteroscopically visible endometrial lesions, 5 had masses, and 11.3% had polyps in endometrium.Using a hysteroscope to assess endometrial vascularity, we discovered that 69 women (86.3%) had a normal vascularity of endometrium, while 11 women (13.7%) had endometrium hyper vascularity.For endometrial pathology, 3 women (3.7%) exhibited atypia and endometrial hyperplasia, 10 females (12.5%) exhibited atypia-free simple endometrial hyperplasia., and two women (2%) had cancer in endometrium.Conclusion: Office hysteroscopy can be regarded as a definitive and very effective method for diagnosing and treating perimenopausal bleeding.