abnormal in volume, regularity, or duration and has been present for the majority of the last

six months It represents one of the most common reasons for gynecologic consultations globally and has

significant implications for a woman’s physical, emotional, and social well-being

Traditionally, evaluation of AUB involves clinical history, physical examination, laboratory

investigations, imaging modalities like transvaginal ultrasound(TVS),and histopathological

assessment via endometrial sampling

However, these approaches often provide incomplete information, especially in cases where

pathologies are focal or subclinical.

The PALM-COEIN classification by FIGO standardizes AUB causes into structural (Polyps,

Adenomyosis, Leiomyoma, Malignancy) and non-structural (Coagulopathy, Ovulatory

dysfunction, Endometrial, Iatrogenic, Not yet classified) categories

While TVS is helpful for assessing uterine morphology, its sensitivity is limited in detecting

intrauterine abnormalities like adhesions, small polyps, or hyperplasia . Hysteroscopy has

revolutionized the diagnostic approach to AUB by allowing direct visualization of the

uterine cavity, making it possible to assess even minute lesions . It has become a

cornerstone in evaluating abnormal uterine bleeding, particularly when structural

abnormalities are suspected or when initial investigations are inconclusive

The integration of hysteroscopy into outpatient settings, coupled with advancements in optics

and instrumentation, has reduced complications, improved patient acceptability, and allowed

for real-time intervention . Studies have demonstrated hysteroscopy’s high sensitivity and

specificity, especially when combined with histological confirmation .

This study aims to highlight the role of diagnostic hysteroscopy as a superior alternative to

blind procedures like dilation and curettage (D&C), emphasizing its utility in identifying

causative pathology and guiding targeted therapy

This study will aim towards bridging the diagnostic gap in Abnormal uterine blreeding

evaluation by validating the role of hysteroscopy in real-world clinical settings This will

involve Correlating hysteroscopic findings with histopathology to assess sensitivity, specificity, and

predictive value .

While hysteroscopy is widely used in tertiary care centers, its adoption in primary or

secondary care is limited, often due to lack of awareness or perceived complexity .

Demonstrating its efficiency and cost-effectiveness could promote wider acceptance and

integration into primary sectors.