Accuracy of endomyometrial biopsy in diagnosis of adenomyosis: A prospective study.

OBJECTIVE

To evaluate the diagnostic accuracy of hysteroscopic endomyometrial biopsy using Spirotome,complemented by transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI), for diagnosis of adenomyosis in patients with abnormal uterine bleeding.

METHODS

A prospective observational study (n = 60) was conducted at Ain Shams University Maternity Hospital. Patients underwent TVUS, MRI, and office hysteroscopy-guided biopsy using the Spirotome before hysterectomy. Biopsy results were compared with final pathology.

RESULTS

Biopsy sensitivity (86.36%), specificity (90%), and overall accuracy (87.5%) were recorded. TVUS demonstrated high sensitivity (100%) but low positive predictive value (66.66%). MRI showed sensitivity of 87.5% and specificity of 75%.

CONCLUSION

This study demonstrates the diagnostic efficacy of hysteroscopic endomyometrial biopsy using a Spirotome, complemented by TVUS and MRI, in adenomyosis diagnosis. A sequential diagnostic approach enhances detection rates, improving patient outcomes. Integrating office hysteroscopy-guided biopsy into diagnostic protocols will provide accurate diagnoses and targeted treatments.