الفهرس 
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Abstract
Adenomyosis is a disease that affects perimenipausal women, causing menstrual and perimenstrual pain, and excessive uterine bleeding. It can cause any type of bleeding whose duration, frequency, and amount are excessive for a certain patient. It is a common reason for gynecological consultation in peri- and postmenopausal women as it makes the patient uncomfortable due to the limitations that it poses, such as the increased need to use tampons and the concern about the cause of bleeding and the possibility of a malignant disease. In addition to the disturbance caused to women, AUB is viewed as a sign for possible uterine diseases, some of which are pre-malignant or malignant.
Many of these patients will undergo office hysteroscopy as part of their diagnostic flowchart to evaluate the uterine cavity, as it has a very high accuracy. Because it is introduced under direct vision, complications are extremely rare, where patients are comfortable and relaxed. In addition, patients undergoing examinations as outpatients have significantly less time off work and have a faster recovery with consequent savings to patients and their physicians.
This study was conducted aiming to evaluating the role of office hysteroscopy as an outpatient procedure in the evaluation of adenomyosis in patients with abnormal uterine bleeding diagnosed by ultrasound as adenomyosis.
The study was conducted on 60 women who had been selected from the outpatient clinic of El Shatby Maternity University Hospital. Diagnostic office hysteroscopy using vaginoscopic approach was performed to all patients without anesthesia or analgesia. Hysteroscopy was performed after clinical examination and exclusion of any case with pelvic infection, Pregnancy Postpartum and Post abortion, to decrease complications during the procedure, and the results showed that:
• The comparison between results of diagnostic office hysteroscopy and transvaginal sonography was:
Diagnostic criteria by TVS were as follows:
• A globular and/or asymmetric uterus in 60% of cases
• A poorly defined focus of abnormal myometrial echotexture in 25% of patients
• Distorted and heterogeneous myometrial echotexture in 10%
• Myometrial linear striations in 5%.
Hysteroscopy findings in the studied patients
• Normal hysterscopic findings were found in (1.75%) ,
• Irregular endometrium with superfacial openings in (57.9%) ,
• Irregular endometrial-myometrial interface (fibrotic, whorled.) in (35.09%),
• Intramural endomtrioma in (5.26%) .
• Excessive vasculature is a universal finding .