Diagnostic hysteroscopy in abnormal uterine bleeding: a five years study in Kathmandu university hospital


  • Abha Shrestha Department of Obstetrics and gynecology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre
  • Bhagirathi Kayastha Department of Obstetrics and gynecology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre
  • Ramesh Makaju Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre




Abnormal uterine bleeding, Dilatation and curettage, Hysteroscopy


Background: Abnormal uterine bleeding is the cause of concern, inconvenience and discomfort to many ladies, this affects millions of women in both developed and developing world.  Until recent times, dilatation and curettage was the usual method of evaluation .This detects the cause of bleeding in less than 50% of the cases, but hysteroscopy is a better diagnostic modality and prompt treatment can be provided in the same setting.

Methods: A prospective study was carried out in the Department of Obstetrics and Gynecology at Dhulikhel hospital, Kathmandu University Hospital, Kavre, Nepal from January 2010 to January 2016. Two hundred and eighteen cases were enrolled in this study. Patients with abnormal uterine bleeding above the age of 18 years were enrolled. Hysteroscopic examination was done in all patients after the pregnancy was ruled out with urine pregnancy test and ultrasonology. The patients then underwent hysteroscopic guided endometrial sampling and endometrium was sent for histopathologic examination. The correlation between findings on hysteroscopy and histopathologic examination was tabulated.  

Results: Following were the findings on hysteroscopy: proliferative endometrium was in 59%, secretary   endometrium was in 14%,endometrial hyperplasia in 12%, atrophic in 2 %, endometrial polyp in 7%, submucous myoma in  5% and carcinoma of endometrium in 1%.

Conclusions: In patients with abnormal uterine bleeding, hysteroscopy provides more accurate diagnosis than dilatation and curettage. 


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Author Biographies

Abha Shrestha, Department of Obstetrics and gynecology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre

Department of Obstetrics and Gynecology,

Associate Professor

Bhagirathi Kayastha, Department of Obstetrics and gynecology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre

Department of Obstetrics and gynecology,


Ramesh Makaju, Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre

Department of Pathology. Associate Professor


Gimpelson RJ, Rappold HO. A comparative study between panaromic hysteroscopy with dircted biopsies and dialatation and curettage: A review of 276 cases. Am J Obstet Gynecol. 1988;158:489–92.

Cohen MR, Paul W. Modern hysteroscopy: Diagnostic and therapeutic potential. Fertil Steril. 1973;12:905–11.

Taneja SP. Hysteroscopy: Past, present and future. Med J Armed Force India. 2002;58:293–4.

Menon MKK, Devi PK, Rao K B. Postgraduate Obstetrics and Gynecology. India: Orient Longman; 1982: 253.

Patil SG, Bhute SB, Inamdar SA, Acharya NS, Shrivastava DS. Role of Diagnostic Hysteroscopy in Abnormal Uterine Bleeding and its Histopathologic Correlation. J Gynecol Endosc Surg. 2009;1(2):98.

Panda A, Parulekar SV, Gupta A. Diagnostic hysteroscopy in abnormal uterine bleeding and histopathological correlation. J Obstet Gynaecol India. 1999;49:74–6.

Loverro G, Bettocchi S, Cormio G, Nicolardi V, Porreca MR, Pansini N, et al. Diagnostic accuracy of hysteroscopy in endometrial hyperplasia. Maturitas. 1996;25:187–91.

Gribb JJ. An aid to gynaecologic diagnosis. Obstet Gynecol. 1960;15:593.

Arslan S, Aytan H, Gunyeli I, Koi O, Tuncay G, Tapisiz OL. Office hysteroscopic evaluation of endometrium: Can we hit the target. Arch Gynecol Obstet. 2004;271:200–2.

Valle RF. Hysteroscopic evaluation of patients with abnormal uterine bleeding. Surg Gynecol Obstet. 1981;153:521–6.

Sheth S, Hamper VM, Kurman R. A study between hysteroscopy with directed biopsies and dialatation and curettage. Am J Obstet Gynecol. 1989;158:489.

Silander T. Hysteroscopy through a transparent rubber balloon. Surg Gynecol Obstet. 1962;114:125–7.

Dexus S, Labastida R, Arias A. Hysteroscopy in abnormal uterine bleeding. In: Siegler AM, Lindemann HJ, editors. Hysteroscopy: Principles and Practice. Philadelphia: JB Lippincott; 1984: 121–1343.

Jyotsana, Manhas K, Sharma S. Role of Hysteroscopy and Laproscopy in evaluation of abnormal uterine bleeding. JK Sci. 2004;6:1.

Acharya V, Mehta S, Randar A. Evaluation of dysfunctional uterine bleeding by TVS, hysteroscopy and histopathology. J Obstet Gynaecol India. 2003;53:170–7.

Mencaglia L. Hysteroscopy and adenocarcinoma. Obstet Gynecol Clin North Am. 1995;22:573–9.

Jong PD, Doel F, Falconer A. Outpatient diagnostic hysteroscopy. Br J Obstet Gynaecol. 1990;97:299–303.

Sciarra JJ, Valle RF. Hysteroscopy: A clinical experience with 320 patients. Am J Obstet Gynecol.1977;127:340–8.

Haller H, Maechjcic N, Rukarina B, Krasevic M, Rupcic S, Mozetic D. Transvaginal sonography and hysteroscopy in women with postmenopausal bleeding. Int J Gynaecol Obstet. 1996;54:155–9.

Litta P, Merlin F, Saccardi C, Pozzan C, Sacco G, Fracas M, et al. Role of hysteroscopy with endometrial biopsy to rule out endometrial cancer in postmenopausal women with abnormal uterine bleeding. Maturitas.2005;50:117–23.

Siegler AM, Valle RF. Hysteroscopic procedures in 257 patients. Fertil Steril. 1976;27:1267–73.

Alwani CM, Ambiye VR, Merchant RM. Diagnostic Hysteroscopy: Preliminary study of 60 cases. Postgraduate Obstetrics Gynecol. 1983;33:250.






Original Research Articles