Journal of Clinical and Investigative Surgery
Tina Bobei1, Romina-Marina Sima1,2, Anca-Daniela Stănescu1,2, Denisa-Oana Bălălău1,2, Liana Pleș1,2
1St. John Emergency Hospital, Bucur Maternity, Department of Obstetrics and Gynecology, Bucharest, Romania
2Carol Davila University of Medicine and Pharmacy, Faculty of General Medicine, Bucharest, Romania
Introduction. Abnormal uterine hemorrhages (AUH) are the most common symptom for presentation to gynecologist. Any uterine bleeding other than menstrual bleeding, which concerns the duration, frequency, quality or quantity of the bleeding is considered abnormal.
Material and Methods. We realized a retrospective study based on medical records of the patients admitted for abnormal uterine hemorrhage at “Saint John” Emergency Clinical Hospital, “Bucur” Maternity between 2013 and 2016. From the patients with AUH, we focused on those who underwent hysteroscopies.
Results. Our study included 146 patients. The age of patients varied from 22 to 71 years. Abnormal uterine bleeding was most prevalent among women of 40-50 years (20%), and the mean age was 42.65%. 82.88% from our patients had obstetrical history and only 17.12% didn’t give birth either as an option, or from primary or secondary infertility. 7.53% of the patients were hypertensive and 5.48% had endocrine pathology. All patients underwent diagnostic hysteroscopy and 4.79% patients therapeutic hysteroscopy. The therapeutic measures that were made are: hysteroscopic resection of the endometrium (47.3%), excision of polyps (36.99%), sinechiolysis (8.22%) and myomectomy (2.71%). The diagnoses were 46.48% endometrial polyp, 13.7% intramural leiomyoma, 13.7% IUD (intrauterine device) and 9.59% intrauterine synechiae, while 15.06% cumulated for uterine septum, endometrial hyperplasia, cervical polyp, foreign intrauterine bodies, secondary infertility, dysfunctional metrorrhagia.
Conclusions. In patients with abnormal uterine hemorrhages, hysteroscopy provides the most accurate diagnosis and can reduce the burden of hysterectomy in many cases.