The Value of Chromohysteroscopy in the Assessment of Postmenopausal Vaginal Bleeding

Abstract

Background: To assess the endometrial changes in postmenopausal patients with vaginal bleeding, using chromohysteroscopy and histopathology, concluding consequently the value of chromohysteroscopy in investigating those patients.

Methods: We included a group of 50 postmenopausal women, presenting with vaginal bleeding, to the outpatient clinic of Cairo University hospital. Transvaginal 2D ultrasonography was performed, followed by hysteroscopy, with chromohysteroscopy performed. Hysteroscopic guided biopsies were obtained from stained areas, then formal curettage done to all uterine walls.

Results: Chromohysteroscopy patterns were either no staining (14%), staining of focal area(s) (76%) or staining of the whole endometrium (10%). Statistical significance was detected between endometrial thickness and chromohysteroscopy. We found a sensitivity 93.75%, specificity 27.77%, PPV 69.76%, and NPV 71.42% of chromohysteroscopy for the pathology obtained.

Conclusion: Chromohysteroscopy improves the efficacy of hysteroscopy in targeting endometrial biopsy. It is though labor intensive and yet not standardized. Studies involving different dyes and larger number of participants are warranted. Inter-observer variability is equally important to help standardizing the procedure.




J Clin Gynecol Obstet. 2014;3(1):35-41
doi: http://dx.doi.org/10.14740/jcgo209w