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Indian Journal of Obstetrics and Gynecology

Volume  5, Issue 3 (Supplement), Jul-Sep 2017, Pages 295-295
 

Original Article

The Role of Hysteroscopy Used as a Diagnostic Tool in the Evaluation of Postmenopausal Bleeding and Its Management Strategies

Yoga Lakshmi S.K., Vidya V. Bhat

Yoga Lakshmi S.K. Fellowship Student of Minimally Invasive Surgery in Radhakrishna Multispeciality Hospital & IVF Centre, Bengaluru, Karnataka, India. Vidya V. Bhat Bstetrician and Gynecologist, Sonologist, and Laparoscopic Surgeon, IVF Specialist and also Director of Radhakrishna Multispeciality Hospital & IVF Centre, Bengaluru, Karnataka, India.

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Abstract

Objectives: 1. to study the role of hysteroscopy as a diagnostic tool in the evaluation of postmenopausal bleeding. 2. To plan management strategies according to the findings in the hysteroscopy procedure. Materials and Methods: Type of the Study: It is a retrospective analysis from June 2012 to June 2017. Setting: In department of obstetrics and gynecology in Radhakrishna. Multispeciality Hospital and IVF centre. • The present study includes 1600 cases of postmenopausal bleeding from June 2012 to June 2017. • Exclusion Criteria: women with history of HRT. Local causes such as bleeding from vagina or cervix known case of bleeding disorder. patient on anticoagulant therapy. • The study includes 1600 cases with history of postmenopausal bleeding for which hysteroscopy was performed and also the patient who required operative treatment was done in same setting. • The HPE findings are divided into 4 categories- Normal, Atrophic endometrium, endometrial hyperplasia & endometrial carcinoma. Results: • 1280 cases were found to have normal or atrophic endometrium for which they were followed up accordingly. • 306 cases were found to have simple hyperplasia medical treatment given for them as first line of management and followed up. • 14 cases with endometrial cancer for which stage wise management was done Conclusion • Hysteroscopy in postmenopausal bleeding patients is a very good diagnostic tool for diagnosing Endometrial carcinoma and to prevent unnecessary surgery in women with normal HPE and simple hyperplasia. • Hysteroscopy along with directed endometrial biopsy proved to be useful diagnostic aid in cases of postmenopausal bleeding.