Hysteroscopic Findings in Women With Menorrhagia

Carlo De Angelis, Antonella Carnevale, Giuseppina Santoro, Italo Nofroni, Marialuigia Spinelli, Maurizio Guida, Luca Mencaglia, Attilio Di Spiezio Sardo

Study Objective

To describe the hysteroscopic findings in patients complaining of menorrhagia to establish any significant association between menorrhagia and benign/malignant intrauterine disorders.

Design

Prospective cohort study (Canadian Task Force classification II).

Setting

University La Sapienza, Rome, Italy.

Patients

One hundred eighteen premenopausal women undergoing office hysteroscopy for menorrhagia (group A) and 344 premenopausal patients undergoing office hysteroscopy for other indications (noncyclic abnormal uterine bleeding, infertility, ultrasonographic abnormalities, etc) (group B).

Interventions

Office hysteroscopy.

Measurement and Main Results

Data on the prevalence of hysteroscopic findings (cervical polyps, endometrial polyps, submucous myomas, low-grade hyperplasia and high-grade hyperplasia/endometrial carcinoma) were compared between group A and group B. The total prevalence, as well as the prevalence of type 0 and type I myomas (totally or >50% intracavitary, respectively), and the mean number per patients with submucous myomas was significantly higher in group A compared with group B (p = .0001, p = .024, and p = .017, respectively). Multivariable logistic regression analysis showed a statistically significant association between age (odds ratio 4.15, 95% confidence interval 1.55–11.1 in the 40- to 49-year age group), presence of submucous myomas (odds ratio 2.76, 95% confidence interval 1.52–5.00), and menorrhagia.

Conclusions

Menorrhagia seems to be associated with aging, the presence and number of submucous myomas, and with the degree of their intracavitary development.

The Journal of Minimally Invasive Gynecology

Volume 20, Issue 2 , Pages 209-214, March 2013