Role of Diagnostic Hysteroscopy in Abnormal Uterine Bleeding, Its Histopathological Correlation, and Associated Metabolic and Endocrine Disorders: A Cross-Sectional Study.

Introduction Abnormal uterine bleeding (AUB) is an exceedingly prevalent complaint in gynecology and can be classified based on the underlying cause, such as a structural abnormality, an endocrine disorder, a metabolic disorder or abnormalities in the endometrium. Objective The objective of this study is to assess the hysteroscopic findings in women with AUB and assess the histopathology of these same women, while at the same time documenting the frequency of co-existing metabolic or endocrine disorders in the women with AUB. Methods This hospital-based cross-sectional study was carried out among 90 women with AUB attending a tertiary care center from April 2020 to April 2022. Consecutive eligible women underwent diagnostic hysteroscopy, followed by endometrial sampling and histopathological examination. Clinical data, metabolic and endocrine disorders, hysteroscopic findings, and histopathological diagnoses were obtained. Histopathological examination was the reference standard for hysteroscopy as a diagnostic modality. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results Participants had a mean age of 35.8 ± 8.6 years, and the majority were females aged 25-35 years. The most frequent endocrine disorder was hypothyroidism, which affected 10 of the women (11.1%). Diabetes mellitus and hypertension each affected four women (4.4%). Hysteroscopy of the uterine cavity identified endometrial polyps in 24 women (26.7%) and endometrial hyperplasia (abnormal uterine lining) in 21 (23.3%), making them the two most prevalent abnormalities. Histopathology confirmed the presence of 24 endometrial polyps (26.7%) and endometrial hyperplasia (22.1%) in 20 women. Hysteroscopy had high diagnostic accuracy, with sensitivities of 91.7% and 88.0%, and specificities of 97.0% and 91.8% for endometrial polyps and endometrial hyperplasia, respectively. There were no complications due to the procedure. Conclusions The use of hysteroscopy to evaluate patients with AUB provided a well-defined correlation between histopathological and hysteroscopic findings. Hysteroscopy was able to accurately identify the most commonly diagnosed problems associated with AUB, such as endometrial polyps and endometrial hyperplasia. It was also able to identify the most frequently diagnosed hormonal disorder: hypothyroidism.