COMPARISON OF DIAGNOSTIC TECHNIQUES USED IN THE DIFFERENTIAL DIAGNOSIS OF ENDOMETRIAL PATHOLOGIES PRESENTING WITH AN ABNORMAL UTERINE BLEEDING

Abstract

Introduction: Transvaginal ultrasonography ( TVUSG ) examination, dilatation and curettage ( D&C ) approach and hysteroscopic assesment are frequently used in examination of the abnormal uterine bleeding ( AUB ). The specisific test for detection of the AUB is histopathological evaluation. The study aimed to check the exactness of TVUSG, D&C and hysteroscopy for differential diagnosis of the AUB.
 Patients and Methodology: Subjects with AUB, who were supposed to have an endometrial pathology on TVUSG, D&C or hysteroscopy, were included in this retrospective study. Our retrospective study was conducted in 160 patients who were admitted to our clinic with complaint of abnormal uterine bleeding. The final pathological diagnosis was accepted as the reference test and sensitivity and specifity of the D&C, hysteroscopy and TVUSG was checked with the pathological diagnosis.
 Results: Hysteroscopy combined with biopsy provieded highest correlation with the histopathological evaluation. However, the statistical values obtained with TVUSG was comparable to that of the hysteroscopy alone and D&C but lower than that of the hysteroscopy combined with biopsy.
 Conclusion: Transvaginal ultrasound is a readily available and reproducible imaging technique for the evalution of the endometrial pathologies leading to the AUB. However, the specificity of the TVUSG is quite low. Among the methods used to correctly identify the endometrial pathologies in our study population, the highest sensitivity and specificity was obtained with hysterosopy combined with the biopsy. Nevertheless, TVUSG provides similar statistical values compared to hysteroscopy alone and D&C.