Objective: To evaluate the role of endometrial dying with methylene blue during diagnostic hysteroscopy to detect new subtle histopathologies missed by the conven-tional hysteroscopy.
Methods: One hundred patients were included in the study complaining of perimenopausal bleeding with no diagnosed hysteroscopic endometrial abnormalities nor a general bleeding tendency. Endometrial dying was done by instillation of 5 ml of 1% methylene blue into the en-dometrial cavity after diagnostic hysteroscopy. Accord-ing to the pattern of methylene blue staining, 60 patients showed focal dark staining with a background of light blue stained endometrium forming (group I), the remain-ing 40 patients showed non focal diffuse blue staining forming ( group II ). Group I was further subdivided into group A , B according to the age with group A (40-46 years) and group B (>46 years)..
Results: Chromohysteroscopy procedure led to the di-agnosis of 48 more new endometrial histopathologies missed by conventional diagnostic hysteroscopy includ-ing 16 cases of atrophic endometritis, 29 cases of simple endometrial hyperplasia and 3 cases of atypical endome-trial hyperplasia.The overall validity of the chromohys-teroscopy procedure was calculated with a sensitivity of 93.2%, specificity of 87.8%, positive predictive value of 91.6 % and negative predictive value of 90%.
Conclusions: Chromohysteroscopy appears to improve the efficacy of hysteroscopy in abnormal uterine bleed-ing and observation of diffuse light blue staining without dark areas strongly suggests a normal endometrium free of endometritis. |
