Management of uterine leiomyoma and adenomyosis: role of hysteroscopy in diagnosis and norethindrone in the treatment.

Abnormal uterine bleeding (AUB) represents a notable sign for benign and malignant uterine pathology. Differentiating adenomyosis from leiomyoma via hysteroscopy aids in selecting appropriate surgical or medical management. Accurate diagnosis is crucial for optimizing fertility outcomes and symptom control. The current study evaluated the diagnostic accuracy of hysteroscopy in differentiating between uterine adenomyosis and leiomymatosis. In addition to; compare between continuous versus intermittent administration of Norethissterone to control both uterine adenomyosis and leiomymatosis. A total of 100 premenopausal women present with AUB. History takin and clinical evaluation was done. All women were subjected to hysteroscopy. Two regimens were used by Norethindrone administration the 1st regimen as continuous manner from day 5 to day 21 46 patients (46%). The 2nd manner was the intermittent type from day 16 and for 10 days 54 patients (54%). Roc-curve of hysteroscopy usage to predict diagnosis; adenomyosis sensitivity was 73.33% and specificity 95.29% and fibroid sensitivity was 73.33% and specificity was 97.65%. Both groups of therapy revealed; highly significant decrease in follow up menorrhagia in continuous Norethindrone group (P < 0.001).By using ROC-curve analysis; Norethindrone administration predicted decreased menorrhagia pain with AUC was 0.973. Hysteroscopy has effective role in differentiating between adenomyosis and fibroids. Yet, long term follows up of abnormal uterine bleeding cases with large sample size in future research are still warranted.