Dysfunctional Uterine Bleeding: the role of Contact Microhysteroscopy in the assessment of endometrial vascularization

Changes in prostaglandins, vascular reactivity, fibrinolytic system, or other autocrine and paracrine uterine factors are presumed to play an important role in the pathogenesis of dysfunctional uterine bleeding (DUB). Here we report the hysteroscopic findings in 34 patients with DUE (mean age 32 years) compared with a control group of 21 normal patients. Hysteroscopic and contact microhysteroscopic results were correlated with clinical and histologic data. Panoramic hysteroscopy was completely normal in all examined cases. Contact microhysteroscopy revealed pseudofunctional dysvascular endometrium (PFDE) in 50% of cases. Although PFDE was present in a large percentage of cases, confirming the functional nature of the disorder, it cannot be considered as a specific diagnostic factor. Future research should clarify if these functional modifications are the causes or the consequences of DUE and whether autocrine or paracrine factors could influence these modifications.