Hakan KILINÇ, HÜSEYİN CENGİZ, Cihan KAYA, Murat EKİN, LEVENT YAŞAR

Endometrial patolojilerin değerlendirilmesinde transvajinal ultrasonografi ile ofis histeroskopinin karşılaştırılması

Amaç: Endometrial patolojiler sık karşılaşılan jinekolojik problemlerden birisidir. Hastalar sıklıkla kliniğe anormal uterin kanama ile başvurmaktadırlar. Çalışmamızda, geriye dönük olarak poliklinik şartlarında transvajinal ultraso nografi (TVUSG) ile endometrial patoloji düşünülen ve ardından ofis histeroskopi (HS) uygulanmış olguların patoloji sonuçlarını analiz ederek TVUSG ve HS’nin endometrial patolojileri saptamadaki etkinliğini araştır mayı amaçladık. Materyal ve Metot: Ocak 2011-Nisan 2011 tarihleri arasında Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Servisi’nde yapı lan TVUSG sonucu endometrial patoloji saptanan, repro düktif ve postmenopozal dönemdeki toplam 116 hasta çalışmaya dahil edildi. Olguların geriye dönük olarak TVUSG bulguları ve ofis HS bulguları tarandı. Bulgular: Patolojik tanı alan 94 (%88,7) olgunun değer lendirilmesi sonucu TVUSG’nin duyarlılığı %95,74, özgül lüğü %8,33, pozitif kestirim değeri %89,11 ve negatif kestirim değeri ise %20,0 olarak tespit edilmiş olup, doğruluk %85,85’tir. Aynı hasta grubunda histeroskopinin duyarlılığı %89,36 olarak; özgüllüğü %25 olarak saptan mıştır. Sonuç: Histeroskopinin anormal uterin kanamalı hasta larda diğer çalışmalarla uyumlu olarak hala en değerli tanı ve tedavi metodu olduğunu düşünmekteyiz. TVUSG ile intrakaviter bir patoloji düşünüldüğünde, ofis histe roskopi göz önünde bulundurulmalıdır.

Anahtar Kelimeler:

Histeroskopi, Uterus hastalıkları, Uterus kanamaları, Ultrasonografi

Comparison of transvaginal ultrasonography with office hysteroscopy in the evaluation of endometrial pathologies

Aim: Endometrial pathologies are common gynecological problems. Patients usually present with abnormal uterine bleeding. In our study, the aim was to detect the efficiency of the transvaginal ultrasound and hysteroscopy by retrospectively analysing the results of the endometrial pathologies that are detected by TVUS or office hysteroscopy after the suspicion of endometrial pathologies in the clinical setting. Material and Methods: The study was conducted in 116 reproductive or postmenopausal patients who had an endometrial pathology, detected by TVUS between January and April 2011 at Bakırkoy Dr Sadi Konuk Teaching and Research Hospital, Obstetrics and Gynecology Department. The patients’ TVUS and office hysteroscopy findings and pathological diagnosis were investigated retrospectively. Results: Ninety four (88, 7%) of the patients had a pathological diagnosis. The sensitivity and the specificity of the TVUSG were 95,74% and 8,33%, respectively. The positive and negative predictive values for the TVUSG were also calculated as 89.11% and 20.0% respectively. Accuracy was 85.85% for transvaginal ultrasonography. The sensitivity and specificity of hysteroscopy were 89,36% and 25%, respectively. Conclusion: We may postulate that hysterescopy is the most valuable procedure in detecting the patients with abnormal uterine bleeding. If an intracavitary abnormality is detected by transvaginal ultrasonography, office hysteroscopy must be considered.

Keywords:

Hysteroscopy, Uterine Diseases, Uterine Hemorrhage, Ultrasonography,

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