Article Data

  • Views 543
  • Dowloads 123

Original Research

Open Access

Accuracy and diagnostic value of outpatient hysteroscopy for malign and benign disease

  • T. Issat1,2
  • J. Beta1,2
  • M.A. Nowicka1
  • A.J. Jakimiuk1,2,*,

1Department of Obstetrics, Women’s Diseases and Oncogynecology, Central Clinical Hospital of Ministry of Interior and Administration, Warsaw

2Center for Reproductive Health, Institute of Mother and Child’s Health, Warsaw (Poland)

DOI: 10.12892/ejgo23692014 Vol.35,Issue 1,January 2014 pp.52-55

Published: 10 January 2014

*Corresponding Author(s): A.J. Jakimiuk E-mail:


Background: The aim of the study was to evaluate accuracy of the outpatient hysteroscopy. Materials and Methods: This was a retrospective cohort study of 494 women who underwent outpatient hysteroscopy after administration of non-steroidal anti-inflammatory agents with the 3.2 mm hysteroscope. Normal saline solution was used as the distension medium. All women were discharged in good general condition afterwards. Results: In cases of abnormal uterine bleeding, there was no apparent pathology found in 112 cases (83.6%). Detection rate (DR) of endometrial polyps was 88.7% with false positive rate (FPR) of 4.6%. Positive predictive value (PPV) was 82.7% with negative predictive value (NPV) of 93.1%. Detection rate (DR) of the submucosal fibroids was 57.7%. Positive predictive value (PPV) was 57.7% with negative predictive value (NPV) of 95.0%. Endometrial cancer was confirmed in ten cases (2.0%), being suspected in eight cases during the procedure. DR in case of the endometrial cancer was 80.0% with FPR of 0.4%. PPV was 66.7% with NPV) of 99.6%. Conclusions: Outpatient hysteroscopy seems to be an effective and accurate diagnostic tool.


Office hysteroscopy; Outpatient hysteroscopy; Hysteroscopy.

Cite and Share

T. Issat,J. Beta,M.A. Nowicka,A.J. Jakimiuk. Accuracy and diagnostic value of outpatient hysteroscopy for malign and benign disease. European Journal of Gynaecological Oncology. 2014. 35(1);52-55.


[1] Cicinelli E., Tinelli R., Loiudice L., Loiudice I., Quattromini P., Fusco A., et al.: “AlphaScope vs lens-based hysteroscope for office polypectomy without anesthesia: randomized controlled study“. J. Minim. Invasive Gynecol., 2011, 18, 796.

[2] Clark T.J.,Voit D., Gupta J.K., Hyde C, Song F., Khan KS.: “Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systematic quantitative review“. JAMA, 2002, 288, 1610.

[3] Farquhar C., Ekeroma A., Furness S., Arroll B.: “A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women“. Acta Obstet. Gynecol. Scand., 2003, 82, 493.

[4] van Dongen H., de Kroon C.D., Jacobi C.E., Trimbos J.B., Jansen F. W.: “Diagnostic hysteroscopy in abnormal uterine bleeding: a sys-tematic review and meta-analysis“. BJOG, 2007, 114, 664.

[5] Marsh F.A., Rogerson L.J., Duffy S.R. “A randomised controlled trial comparing outpatient versus day case endometrial polypectomy“. BJOG, 2006, 113, 896.

[6] Clark T.J., Mahajan D., Sunder P., Gupta J.K.: “Hysteroscopic treatment of symptomatic submucous fibroids using a bipolar intrauterine system: a feasibility study“. Eur. J. Obstet. Gynecol. Reprod. Biol., 2002, 100, 237.

[7] Prasad P., Powell M.C.: “Prospective observational study of Thermablate Endometrial Ablation System as an outpatient procedure“. J. Minim. Invasive Gynecol., 2008, 15, 476.

[8] Sinha D., Kalathy V., Gupta J.K., Clark T.J.: “The feasibility, success and patient satisfaction associated with outpatient hysteroscopic sterilisation“. BJOG, 2007, 114, 676.

[9] Lau W.C., Ho R.Y., Tsang M.K., Yuen P.M.: “Patient’s acceptance of outpatient hysteroscopy“. Gynecol. Obstet. Invest., 1999, 47, 191.

[10] RCOG Green-top Guideline No. 59 Best Practice in Outpatient Hysteroscopy?

[11] Mencaglia L., Perino A., Hamou J.: “Hysteroscopy in perimenopausal and postmenopausal women with abnormal uterine bleeding“. J. Reprod. Med., 1987, 32, 577.

[12] Emanuel M.H., Verdel M.J., Wamsteker K., Lammes FB.: “A prospective comparison of transvaginal ultrasonography and diagnostic hysteroscopy in the evaluation of patients with abnormal uterine bleeding: clinical implications“. Am. J. Obstet. Gynecol., 1995, 172, 547.

[13] Metzger U., Bernard J.P., Camatte S., Lelièvre L., Robin F., Lefrère-Belda M.A, Lécuru F. Sono-guided endometrial biopsy: comparison with hysteroscopy biopsy. Sono-guided endometrial biopsy using the Bernard catheter had no impact on endometrial assessment by sonohysterography“. Gynecol. Obstet. Invest., 2004, 58, 26. Epub 2004 Mar 18.

[14] Kelekci S., Kaya E., Alan M., Alan Y., Bilge U., Mollamahmutoglu L.: “Comparison of transvaginal sonography, saline infusion sonography, and office hysteroscopy in reproductive-aged women with or without abnormal uterine bleeding“. Fertil. Steril., 2005, 84, 682.

[15] Fong K., Kung R., Lytwyn A., Trudeau M., Chapman W., Nugent P., et al.: “Endometrial evaluation with transvaginal US and hysterosonography in asymptomatic postmenopausal women with breast cancer receiving tamoxifen“. Radiology, 2001, 220, 765.

[16] Dijkhuizen F.P., Brölmann H.A., Roumen R.M., Bastin F.H., Heintz A. P.: “Increase in risk of endometrial carcinoma following treatment of breast carcinoma with tamoxifen“. Ned. Tijdschr. Geneeskd., 1995, 139, 2393.

[17] Parsons A.K., Lense J.J.: “Sonohysterography for endometrial abnormalities: preliminary results“. J. Clin. Ultrasound, 1993, 21, 87.

[18] Dijkhuizen F.P., De Vries L.D., Mol B.W., Brölmann H.A., Peters H. M., Moret E., Heintz A.P.: “Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women“. Ultrasound Obstet. Gynecol., 2000, 15, 372.

[19] Williams C.D., Marshburn P.B.: “A prospective study of transvaginal hydrosonography in the evaluation of abnormal uterine bleeding“. Am. J. Obstet. Gynecol., 1998, 179, 292.

[20] Gull B., Karlsson B., Milsom I., Granberg S.: “Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer“. Am. J. Obstet. Gynecol., 2003, 188, 401.

[21] Maia H. Jr., Barbosa I.C., Farias J.P., Ladipo O.A., Coutinho E.M.: “Evaluation of the endometrial cavity during menopause“. Int. J. Gynaecol. Obstet., 1996, 52, 61.

[22] Smith-Bindman R., Kerlikowske K., Feldstein V.A., Subak L., Scheidler J., Segal M., et al. Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities. JAMA, 1998, 280, 1510.

[23] Clark T.J., Voit D., Gupta J.K., Hyde C., Song F., Khan K.S.: “Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systematic quantitative review“. JAMA, 2002, 288, 1610.

[24] Gimpelson R.J.: “Panoramic hysteroscopy with directed biopsies vs. dilatation and curettage for accurate diagnosis“. J. Reprod. Med., 1984, 29, 575.

[25] Gimpelson R.J., Rappold H.O.: “A comparative study between panoramic hysteroscopy with directed biopsies and dilatation and curettage. A review of 276 cases“. Am. J. Obstet. Gynecol., 1988, 158, 489.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time