Abnormal uterine bleeding: office vaginohysteroscopy as a diagnostic and therapeutic method.

Abstract

Abnormal uterine bleeding (AUB) is one of the most frequent reasons for consultation in gynecology (18% - 30%) and includes a wide range of disorders from endocrinological, infectious, anatomical alterations, to malignant pathology. Vaginohysteroscopy (VH) is considered the gold standard for the evaluation of intracavitary pathology in patients with SUA. Objective: To analyze the findings found in the vaginohisteroscopies performed in the Hysteroscopy unit of the Department of Obstetrics and Gynecology of Centro Médico Docente La Trinidad (CMDLT), from January 2014 to April 2024, in patients with AUB. Methods: observational, descriptive, retrospective and cross-sectional study. Sample made up of 360 reports, divided between women of reproductive and postmenopausal age. Results: 228 (63%) patients of reproductive age consulted, while 132 (37%) were postmenopausal. 336 (93.33%) VH with pathological findings were obtained and only 24 (6.67%) reported without pathology. In reproductive age the main findings were isthmocele (29.52%), endometrial polyp (36.67%), leiomyoma (14.76%); and in the postmenopause they were endometrial polyp (44.7%), findings suggestive of endometrial cancer (22%), endometrial atrophy (13.6%). It was observed that 44.94% of the patients received surgical treatment in the office, 39.88% were referred to the operating room, 8.33% did not require treatment and 6.85% received medical treatment. Conclusions: The importance of VH in the evaluation and management of AUB is highlighted, contributing to a better understanding of the causes of AUB, allowing for a more precise and less invasive treatment to be offered. Furthermore, the need for research on isthmocele is highlighted.