Chromohysteroscopy—A new technique for endometrial biopsy in Abnormal Uterine Bleeding (AUB)

Nisha Singh, Bharti Singh

Department of Obstetrics & Gynecology, King George Medical University, Lucknow, India.

DOI: 10.4236/ojog.2013.35A1003                

Abstract

Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB. Design: Cross sectional interventional study. Materials and Methods: This study was conducted on 60 women with AUB in Dept. of Obst. & Gyne at King George Medical University, Lucknow over a period of one year. All cases underwent diagnostic hysteroscopy followed by chromohysteroscopy using 2% methylene blue dye. Hysteroscopic guided biopsy was taken from stained and unstained areas followed by an endometrial aspiration biopsy from whole uterine cavity. The histopathology results of three samples were compared and analyzed in relation with staining pattern and type of AUB. Data analysis was done on SPSS version 15 of windows 2007. Results: Out of 60 cases, 11cases were found to have non hormonal pathology after chromohysterosopic biopsy. Eight (72.72%) cases were diagnosed by stained endometrial tissue, one (9.09%) by unstained tissue and three (27.27%) by endometrial aspiration. The diagnostic ability of stained tissue biopsy was significantly higher (p = 0.006) than unstained biopsy and endometrial aspiration. Conclusion: Chromohysteroscopy is a simple and effective technique for diagnosing endometrial pathology in cases of AUB.

Keywords

Endometrial Biopsy; Endometrial Aspiration; Hysteroscopy; Menstrual Abnormality; Methylene Blue Dye

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Shayder, J.M. (2000) Pathophysioogy of abnormal uterine bleeding. Obstetrics & Gynecology Clinics of North America, 27, 219-234. doi:10.1016/S0889-8545(00)80017-0
[2]	Ragunath, K., Krasner, N., Raman, V.S., et al. (2003) A randomized, prospective cross-over trial comparing methylene blue-directed biopsy and conventional random biopsy for detecting intestinal metaplasia and dysplasia in Barrett’s esophagus. Endoscopy, 35, 998-1003. doi:10.1055/s-2003-44599
[3]	Valle, R.F. and Sciarra, J.J. (1988) Intrauterine adhesions: Hysteroscopic diagnosis, classification, treatment, and reproductive outcome. American Journal of Obstetrics & Gynecology, 158, 1459-1470
[4]	Lim, C.H., Rotimi, O., Dexter, S.P.L., et al. (2006) Randomized crossover study that used methylene blue or random 4-quadrant biopsy for the diagnosis of dysplasia in Barrett’s esophagus. Gastrointestinal Endoscopy, 64, 159. doi:10.1016/j.gie.2005.07.025
[5]	Stevens, P.D., Lightdale, C.J., Green, P.H., et al. (1994) Combined magnification endoscopy with chromoendoscopy for the evaluation of Barrett’s esophagus. Gastrointestinal Endoscopy, 40, 747-749.
[6]	Gossner, L., Pech, O., May, A., et al. (2006) Comparison of methylene blue-directed biopsies and four-quadrant biopsies in the detection of high-grade intraepithelial neoplasia and early cancer in Barrett’s oesophagus. Digestive and Liver Disease, 38, 724-729. doi:10.1016/j.dld.2006.05.025
[7]	Kucuk, T. and Safali, M. (2008) Chromohysteroscopy for evaluation of endometrium in recurrent in vitro fertilization failure. Journal of Assisted Reproduction and Genetics, 25, 79-82.
[8]	Kucuk, T. (2008) Chromohysteroscopy and quot for evaluation of endometrium in recurrent miscarriage. Clinical & Experimental Obstetrics & Gynecology, 35, 133-136.
[9]	Mansoura, H. and Mohamed, A. (2011) value of endometrial dyeing in diagnosis of endometritis in absence of macroscopic abnormalities during hysteroscopy. Middle East Fertility Society Journal, 16, 83-86.
[10]	Matsumotu, T., Nakamura, S., Jo, Y., et al. (2003) Chromoscopy might improve diagnostic accuracy in cancer surveillance for ulcerative colitis. The American Journal of Gastroenterology, 124, 880-888.
[11]	Kucuk, T. and Deveci, S. (2008) Chromohysteroscopy help target endometrial biopsy in postmenopausal bleeding. European Journal of Gynaecological Oncology, 29, 165-167.