Diagnostic and therapeutic hysteroscopy in the management of abnormal uterine bleeding.

Three hundred seventy cases of abnormal uterine bleeding that occurred from January 1985 to June 1989 were studied. Diagnostic and operative hysteroscopy was performed as an outpatient procedure. Included in the study were all patients with dysfunctional uterine bleeding that did not respond to progestogens for three months, patients with severe menometrorrhagia and those with postmenopausal bleeding. Patients with pregnancy-associated bleeding, obvious uterine enlargement, polycystic ovary disease and abnormal cervical smears were excluded. The ages of the patients ranged from 22 to 82 years. The uterine cavity was found to be normal in 33.51%. Polyps were found in 21.53% of cases, submucous myomata in 11.35%, endometrial hyperplasia in 22.97%, endometrial atrophy in 1.62%, synechiae in 5.67% and adenocarcinoma in 1.35%. Targeted biopsies, excision of polyps, removal of myomata (with scissors and resectoscope) and curettage were performed as necessary.