Accuracy of endomyometrial biopsy in diagnosis of adenomyosis: A prospective study

Abstract

OBJECTIVE: To evaluate the diagnostic accuracy of hysteroscopic endomyometrial biopsy using Spirotome,complemented by transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI), for diagnosis of adenomyosis in patients with abnormal uterine bleeding. METHODS: A prospective observational study (n = 60) was conducted at Ain Shams University Maternity Hospital. Patients underwent TVUS, MRI, and office hysteroscopy-guided biopsy using the Spirotome before hysterectomy. Biopsy results were compared with final pathology. RESULTS: Biopsy sensitivity (86.36%), specificity (90%), and overall accuracy (87.5%) were recorded. TVUS demonstrated high sensitivity (100%) but low positive predictive value (66.66%). MRI showed sensitivity of 87.5% and specificity of 75%. CONCLUSION: This study demonstrates the diagnostic efficacy of hysteroscopic endomyometrial biopsy using a Spirotome, complemented by TVUS and MRI, in adenomyosis diagnosis. A sequential diagnostic approach enhances detection rates, improving patient outcomes. Integrating office hysteroscopy-guided biopsy into diagnostic protocols will provide accurate diagnoses and targeted treatments.