Citation Information :
Sonawane SS, Kathaley M. Advanced Hysteroscopy: Can It Be Safe and Effective Alternative to Hysterectomy in Perimenopausal AUB?. World J Lap Surg 2025; 18 (1):26-29.
Background: Abnormal uterine bleeding (AUB) is one of the most common indications for hysterectomy in perimenopausal age-group patients. Due to inadequate and varied response to medical management, fear of malignancy and lack of awareness, patients prefer to opt for hysterectomy. The incidence of unwanted hysterectomies is increasing particularly in rural and tribal populations in our country. Hysteroscopy is considered the gold standard technique for diagnosing and managing pathological conditions affecting the uterine cavity. Immediate treatment of endocervical, endometrial, or submucosal pathologies is possible with advanced operative hysteroscopy and it is associated with high patient satisfaction. Major surgery like hysterectomy can be avoided in case of benign uterine pathologies.
Aims and objectives: To evaluate the role of advanced hysteroscopy in perimenopausal age-group patients with chronic AUB and to study the effect of operative hysteroscopy on improvement in the quality of life of perimenopausal AUB patients.
Materials and methods: It was a retrospective study conducted over a period of one and a half year. 128 patients of age-group 35–50 years with AUB who had undergone hysteroscopy were included. Any demonstrable pelvic pathologies like pelvic malignancies and active pelvic inflammatory diseases were set as an exclusion criteria. Institutional standard operating protocol for hysteroscopic surgeries was followed. As per the protocol experienced senior faculties were the operating surgeons for all the cases. Demographic characteristics, hysteroscopic findings, and histopathology reports were correlated. All the patients were followed up for 6 months after hysteroscopic surgery.
Results: A significant number of patients were diagnosed with intracavitatory lesions and they were managed successfully through operative hysteroscopy. Patients were satisfied with their quality of life after hysteroscopic surgeries.
Conclusion: Operative hysteroscopic surgeries have been shown to be effective in treating AUB and possibly avoiding or delaying hysterectomy in perimenopausal women.
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