Publication:

A comparative study of hysteroscopy and transvaginal ultrasonography in diagnosis of endometrial pathology in abnormal uterine bleeding

Background Abnormal uterine bleeding is the most common complaint in gynaecology and an important source of morbidity. The ideal diagnostic tool to determine the cause for the same continues to be debated. Objective of this study was to compare accuracy of hysteroscopy and transvaginal sonography in diagnosis of endometrial pathology in abnormal uterine bleeding.

Methods A total 100 women attending gynaecological outpatient in hospital attached to J. J. M. Medical College, Davangere with abnormal uterine bleeding fitting into the inclusion criteria during November 2014 to August 2016, were admitted and evaluated with Transvaginal sonography (TVS) and hysteroscopy. Data was collected and analysed.

Results Among 100 patients of AUB in this study, majority of the patients were in perimenopausal age group. Menorrhagia is the most common presentation (45%) followed by postmenopausal bleeding (20%). Anaemia was detected in 79% of patients. Hysteroscopy was taken as gold standard and TVS findings were compared. The sensitivity of TVS in detecting polyps, submucous fibroid were 22.2%, 11% respectively and for the normal variants like proliferative and secretory it was 50% and 79.2% respectively. TVS showed good correlation with hysteroscope findings for normal variants of endometrium, but poor correlation for intracavitary pathologies.

Conclusions Hysteroscopy is a rapid, safe, well tolerated and highly accurate means of diagnosing the cause of abnormal uterine bleeding in perimenopausal age group. Thus, it is advised as a first line investigation in evaluation of AUB.