Comparison of Transvaginal Ultrasonography and Diagnostic Hysteroscopy in the evaluation of patients with Abnormal Uterine Bleeding

Abstract

This study was performed at SCU Teaching Hospital during the period from August 1997 to August 1998. We aimed at evaluating the role of Trans-Vaginal Sonography (TVS) in the detection of the cause of undiagnosed uterine bleeding as compared to hysteroscopy and histopathological ex@llination of endometrial curettage. This study composed of 44 patients attending the gynecologic outpatient clinic in our hospital and presenting with abnormal uterine bleeding. After a detailed medical history and a thorough general, abdominal and pelvic examinations; a definite diagnosis for the cause of bleeding was not reached. Therefore patients were subjected to TVS, hysteroscopy and fractional curettage. Hysteroscopy and histopathological examination of the endometrium were used as the gold standard control for evaluating the accuracy of TVS in diagnosing intrauterine and endometrial causes for the bleeding. The average age of the patients was 45.0 ± 6.8 years. Only 6 patients were postmenopausal (13.6 %) with average age of56.01 ± 4.0 years. The average parity was 3.6 ± 2.2. Seventy seven percent of the patients required dilatation before hysteroscopy. No endometrial or intrauterine pathology was found in 75 %, 73% and 68 % by TVS, hysteroscopy and histopathological examination, respectively, and the cause of bleeding was therefore consideredofthe dysfunctional type and treated accordingly. The pathological lesions found by the three modalities were submucous fibroid, endometrial polypi and endometrial thickening (hyperplasia). There were no cases of endometrial carcinoma detected.