In 107 patients, 75 with abnormal uterine bleeding and 32 with infertility, diagnostic hysteroscopy with CO2 distention was done for detection of any abnormal uterine or endometrial findings and for assessment of the endometrial hormonal pattern. Eighty one patients were in the child bearing age, 19 were premenopausal and 7 were menopausal. Hysteroscopy was followed by endometrial biopsy ''or assessment of the endometrial hormonal pattern histologically. Endometrial and uterine lesions were found in 38 patients (35.5%) including; 15 submucous myomata, 9 endometrial polypi, 2 cervical polypi, 4 intrauterine adhesions, 1 adenomyosis and 6 congenital uterine anomalies. In 88 patients, tape hysteroscopic endometrial pattern agreed with the histological diagnosis (79.4%), and disagreed In 22 patients (20.6%).
The false positive hysteroscopic diagnosis rate was 9.3% for secretory endometriurn, was 5.6% for proliferative endometrium, was 2.9% for endometrial hyperplasia and was 1.9% for atrophic endometrium. The diagnostic accuracy of hysteroscopy, compared to histology, was 61.5% for secretory endometrium, was 77.8% for proliferative endmetrium and was 81.8% for both hyperplastic and atrophic endometrium. Hysteroscopy is essential for accurate diagnosis of endometrial lesions, especially small ones that can be missed by curettage or biopsy. Histology is essential 4or precise diagnosis of endometrial hormonal pattern, especially hyperplasia in which hysteroscopy is Incapable of accurate diagnosis of its type.
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