Abnormal
uterine bleeding is perhaps the commonest gynecological
problem that women of reproductive and perimenopausal
age face. It is estimated that 20-30% of all women face
this problem sometime during their lives. It is also estimated
that 12% of all referrals to gynecologists and 60% of
all hysterectomies that are carried out are for the management
of AUB.
In
the past, diagnosing AUB was primarily on clinical examination
and D&C procedures. D&C was considered to be the
gold standard diagnostic procedure in the past. It is
now proven that conventional D&C is an inadequate
diagnostic and therapeutic tool. It has been shown to
miss 62.5% of all major intra-uterine lesions. Emphasis
is now placed on using multiple diagnostic tools such
as pelvic ultrasound, sonohysterogram and office hysteroscopic
procedures for more accurate and specific diagnosis.
Hormone
therapy or hysterectomies were the only modalities of
treatment available in the past. However now women have
wider variety of options prior to resorting to definitive
surgery like hysterectomy. Non invasive management like
LNG IUCD (Progesterone containing intrauterine system)
has decreased blood loss up to 80%. Minimal access procedures
such as thermal ballon ablation of endometrium (Thermochoice)
also offer very effective simple cures avoiding the risk
of surgery. Worldwide, hysterectomy still has a mortality
rate of 1 in 1000, occasional risk of Major complication
of 13% and morbidity rate of 24%.
Women's
center has been offering these elegant diagnostic procedures
and low risk, highly effective non-surgical options for
the management of abnormal uterine bleeding for the benefit
of its patients.