Hysteroscopy in Abnormal Uterine Bleeding: Correlation with Histopathological Findings

Background: Abnormal uterine bleeding (AUB) is a common gynecological condition that significantly affects women's quality of life. It is a leading cause of consultation in gynecological practice and can be associated with various underlying pathologies, ranging from benign conditions such as fibroids and polyps to more serious diseases like endometrial cancer. The evaluation and diagnosis of AUB are crucial for determining appropriate management strategies. Hysteroscopy, a minimally invasive diagnostic procedure, allows for direct visualization of the uterine cavity and is increasingly used for the evaluation of AUB. When combined with histopathological examination, it offers a more comprehensive assessment and aids in establishing a definitive diagnosis. Objective: The aim of this study is to evaluate the role of hysteroscopy in diagnosing the causes of abnormal uterine bleeding and to correlate the hysteroscopic findings with histopathological results. Methods: This study is a retrospective analysis conducted at Department of Obstetrics and Gynaecology, Katihar Medical College, and Hospital, Katihar, Bihar, India for one year, involving 150 women presenting with abnormal uterine bleeding. All participants underwent hysteroscopy, and tissue samples were collected for histopathological examination. The correlation between hysteroscopic findings and histopathological diagnoses was analyzed. The data were reviewed to identify the most common causes of AUB and the concordance between hysteroscopic and histopathological findings. Results: The study found that the most common causes of AUB were endometrial polyps (30%), fibroids (25%), and endometrial hyperplasia (20%). Hysteroscopy successfully identified these conditions, with a high degree of correlation to histopathological findings. However, discrepancies between hysteroscopic and histopathological diagnoses were noted in a small percentage of cases, particularly in women with endometrial hyperplasia and carcinoma. Conclusion: Hysteroscopy, in conjunction with histopathological examination, is a valuable tool in the diagnosis and management of abnormal uterine bleeding. It not only helps in identifying the structural abnormalities in the uterine cavity but also provides a definitive diagnosis when combined with histopathological analysis. The combined approach significantly improves the accuracy of diagnosis and guides targeted therapeutic interventions, particularly in cases where the etiology of bleeding is uncertain.