Transvaginal ultrasonography versus hysteroscopy in endometrial pathology diagnosis among women with abnormal uterine bleeding

Abstract

Objective: Abnormal uterine bleeding is any deviation from a normal menstrual pattern. Transvaginal ultrasonography is useful in determining endometrial thickness but cannot conclusively exclude sessile and pedunculated lesions. Hysteroscopy is an invasive procedure that detects discrete lesions. This study was aimed to evaluate the diagnostic accuracy of 2-dimensional transvaginal ultrasonography and hysteroscopy in evaluating endometrial lesions in women with abnormal uterine bleeding, by determining the sensitivity and specificity of the two methods in diagnosing the lesions. Methods: Eighty-four cases of abnormal uterine bleeding were chosen based on inclusion criteria. The patients were subjected to routine investigations. The findings of transvaginal ultrasonography, hysteroscopy, and dilatation and curettage were compared and analyzed. Results: Maximum incidence of abnormal uterine bleeding was observed in women between 41 and 50 years of age (73.8%). The most common presenting complaint was menorrhagia (76.1%). 76% of patients experienced symptoms for less than six months. The sensitivity and specificity of transvaginal ultrasonography were 60% and 96.3%, respectively. The sensitivity and specificity of hysteroscopy were 80.4% and 93.1%, respectively. The accuracy of transvaginal ultrasonography was 60.3%, and that of hysteroscopy was 83.3%. Conclusion: Transvaginal ultrasonography and hysteroscopy can be used as first-line diagnostic modalities to rule out and find the causes of abnormal uterine bleeding, which can aid in instituting prompt and appropriate medical treatment.