We have retrospectively evaluated the role of hysteroscopy for the diagnostic of the peri-menopausal metrorrhagia.
Methods: The cases included represented patients of more than 45 years, with persistent bleeding, from 2 gynecological hospitals (one public and one private), during one year, that were submitted to hysteroscopy for clarifying the diagnostic. The hysteroscopic endometrium descriptions were categorized as: atrophy, normal, simple or suspect hypertrophy, polyp, and adenocarcinoma, and they were compared to the pathological exam results.
Results: The descriptions were distributed among the categories: atrophy (8 cases), simple hypertrophy (17), suspect hypertrophy (3), polypoid (5), endometrial cancer (2) or normal (4). The correlation to pathological results was good, with only 14% of hysteroscopic underestimation of lesions. The sensitivity according to type of pathology, was 50 to 100%, specificity between 84% - 100%.
Conclusion: Hysteroscopy is better than "blind" curettage in clarifying perimenopausal hemorrhagic endometrial pathology.