Tehran University Medical Journal

Background: Abnormal uterine bleeding (AUB) is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C) which is the current gold standard procedure.

Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery.

Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone.

Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.

Background: To evaluate long-term outcome and satisfaction of MacIndo surgery with and without amnion graft.

Methods: This is a historical cohort study of patients who were treated with the McIndo procedure for vaginal agenesis. Participants answered a structured questionnaire to describe outcome in sexual function and satisfaction. Patient characteristics along with short and long-term endings were abstracted from the medical records.

Results: Thirty-five patients responded to the questionnaire. Average age (±SD) at surgery was 28.4 ± 3 years (range 17- 48 years). The mean number of years (±SD) since surgery was 7 years (range 2-12 years). In 15 patients (42.8%) amniotic graft were amniotic graft were used only in is patients (42.8%). There was no relation between two types of surgery (long-term outcome and satisfaction with p-values of 0.346 and 0.758 respectively).

Conclusions: Since there was not a statistical difference between these two types of McIndo methods, it is recommended to apply the procedure in which amnion is not used. This procedure (without amnion graft), is an easier method with less operation time and reduced viral (HIV…) transmission.