الفهرس | Only 14 pages are availabe for public view |
Abstract 1- The diagnostic hysteroscopy has an excellent sensitivity (96.5%) in the diagnosis of various causes of abnormal uterine bleeding in the study group compared with a (66%) sensitivity of TVS. Moreover operative HSC was performed at the same time in some cases to complete the management, and in the rest of cases, target biopsy was taken for final histopathological diagnosis of the cause of bleeding. Inspite of lower sensitivity of TVS than HSC, TVS is considered inseparable complementary diagnostic tool to HSC because it select the suitable cases for HSC, exclude the extrauterine causes of AUB and determine if HSC can be postponed for medical treatment. 2- D & C biopsy has a weak sensitivity (45%) in comparison to histopathology after hysterectomy and the management of cases determined according to its results leading to many cases of failed treatment and ultimately hysterectomy. 3- Medical treatment has a success rate of 45% compared to 90% for TCRE. The medical treatment in this study was non specific haemostatic and hormonal therapy by either gestagen alone or sequential oestrogen and progesterone. To improve the outcome of medical treatment, it should be performed after specific diagnosis of the ease by HSC and target biopsy and according the selective therapy with proper dose and follow up is recommended. Any how medical treatment has a major role in the control of systemic causes and iatrogenic causes of AUB. |