Hysteroscopic Findings in Women With Menorrhagia

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. Journal of Minimally Invasive Gynecology (2013) 20, 209-214 (C) 2013 AAGL. All rights reserved.