Vol. 7, Issue 1, Part A (2025)

Background: AUB represents a common gynecological issue which causes substantial life quality deterioration and health consequences for women between reproductive age and perimenopause. The initial treatment approach for AUB is medical but patients who do not respond to conservative methods need surgical intervention.
Objective: This research aims to analyze both therapeutic outcomes and diagnostic precision of surgical treatments used for AUB patients at Tikrit Teaching Hospital.
Methodology: The research design for this prospective observational cohort study spanned twelve months from January 2024 through January 2025 and enrolled 200 women older than 18 years who had AUB without medical treatment success. The study participants received complete medical evaluation and laboratory tests (CBC, coagulation profile, TFTs, hormonal profile, etc.) and radiological tests (TVUS, SIS, hysteroscopy). The surgical procedures followed FIGO PALM-COEIN classification and involved D&C, hysteroscopic polypectomy, myomectomy, endometrial ablation and hysterectomy. The study tracked patient outcomes during three months of post-treatment observation.
Results: Menorrhagia appeared as the most common symptom in patients since it affected 46% of them. The TVUS examination revealed pathological findings in 61% of patients where endometrial polyps and fibroids proved to be the most common abnormalities. The majority of patients had benign histopathological results but endometrial carcinoma was diagnosed in 3% of cases. The procedure benefited many patients through both diagnostic and therapeutic capabilities of hysteroscopy. The surgical examination showed that 87% of patients achieved full symptom relief with only minor side effects.
Conclusion: The results indicate that surgical intervention serves as a safe and effective treatment option for AUB patients who do not respond to medication. The diagnosis from imaging and histology functions as a vital instrument to determine suitable treatment options.