MICROHYSTEROSCOPY AND ENDOMETRIAL BIOPSY RESULTS FOLLOWING FAILED DIAGNOSTIC DILATATION AND CURETTAGE IN WOMEN WITH POSTMENOPAUSAL BLEEDING

OBJECTIVE: The aim of this study was twofold: firstly to evaluate and compare the diagnostic precision of the microhysteroscopy (MH) and end ometrial biopsy in a group of menopausal women in whom D&C had failed to obtain an adequate endometrial sample, and secondly to quantitate t he value of a hysteroscopy in determining endometrial sampling in thes e patients. METHODS: A Hamou type II CO2 microhysteroscope (MH) was us ed to evaluate the endocervical canal and the uterine cavity, followed by endometrial sampling. RESULTS: Thirty-nine women were assessed usi ng MH and endometrial biopsy. Histopathology results were available fo r diagnosis in 29 of them (74.3%). In the remaining ten patients, the MH diagnosis was atrophic endometrium. Biopsy results corroborated wit h MH in 86.2% (25129) of the patients with tissue samples. The analysi s (r) of this concordance rate was statistically significant (r = 0.96 ). Sample results for patients with MH determined pathological and nor mal endometrium corroborated in 83% and 91%, respectively, inclusive o f three cases of endometrial adenocarcinoma. The sensitivity, specific ity and predictive values for MH alone were 93.7%, 76.9% and 83.3%, re spectively. CONCLUSIONS: These significant results are indicative that this simplified endoscopic method surpasses all blind hospital or off ice endometrial sampling methods. Therefore, we suggest that MH and en dometrial sampling should be the initial assessment tool for any type of indication requiring endometrial and uterine cavity assessment.