A Study on the Role of Chromohysteroscopy in the Evaluation of Endometrial Pathology

Abstract

Chromohysteroscopy is an advanced technique that involves use of special dyes during hysteroscopy to enhance the visualization of endometrial abnormalities. However, its diagnostic value and clinical utility remain a subject of ongoing debate. This study aims to evaluate the effectiveness of chromohysteroscopy in diagnosing endometrial pathology versus conventional hysteroscopy.

Methods We include a group of 45 women presenting with complaints of infertility, heavy menstrual bleeding, Intermenstrual bleeding and Postmenopausal bleeding presented during a period of 12 months in the department of Obstetrics and Gynaecology, at a tertiary care centre, South India, from July 2022 to June 2023.

The first conventional hysteroscopy was done. Then, after instillation of methylene blue dye, hysteroscopic guided biopsies were obtained from stained and unstained areas. All three samples were sent for histopathological examination. Results were analysed and compared.

Results Chromohysteroscopy-guided endometrial biopsy (CHPE) identified 13 cases of endometrial pathology, whereas conventional hysteroscopic-guided biopsy detected seven cases and missed six. The diagnostic accuracy of CHPE in evaluating endometrial pathology was 77.8%, with a sensitivity of 71.4%, specificity of 78.9%, positive predictive value (PPV) of 38.5%, and negative predictive value (NPV) of 93.8%.

Conclusion In conclusion, chromohysteroscopy enhances the diagnostic efficacy of histopathology by facilitating targeted endometrial biopsy, even in the absence of macroscopic abnormalities. This technique provides a notable advantage over conventional methods, particularly in improving the detection of endometrial pathology. However, while it represents a significant advancement, chromohysteroscopy cannot be regarded as an absolute substitute for conventional biopsy techniques.