Assessment of transvaginal ultrasonography accuracy in the diagnosis of uterine pathologies in women with abnormal uterine bleeding

Abstract Background: The most common causes of abnormal uterine bleeding in women of reproductive age are uterine structural abnormalities. There are several modalities for the examination of abnormal uterine bleeding, including transvaginal ultrasound and hysteroscopy. In this study, we aimed to investigate the diagnostic accuracy of hysteroscopy versus transvaginal ultrasound in the diagnosis of common causes of abnormal uterine bleeding. Material and Methods: This was a cross-sectional study on a sample of women with abnormal uterine bleeding who underwent transvaginal ultrasonography and hysteroscopy for diagnosis and treatment. The diagnostic accuracy of transvaginal ultrasound was evaluated for the diagnosis of uterine polyps, endometrial hypertrophy, sub-mucosal myoma, and normal endometrium, in comparison with the diagnostic results obtained from hysteroscopy. Result: In all 119 patients were approached. Of these, 109 patients were entered into the study. The most common causes of abnormal uterine bleeding based on transvaginal ultrasound were uterine polyps, sub-mucosal myoma and endometrial hypertrophy, respectively. The transvaginal ultrasound had a sensitivity of 58.9%, 51.7% and 72.2% for the diagnosis of above pathologies. The specificity of transvaginal ultrasound for the diagnosis of these lesions were: 76.8%, 86.4% and 78.5%, respectively. Conclusion: Transvaginal ultrasound has almost moderate sensitivity and high specifity for the diagnosis of common etiologies of abnormal uterine bleeding including endometrial polyps, endometrial hypertrophy as well as sub-mucosal myomas. The final result of this study revealed that the difference between diagnostic accuracy of transvaginal ultrasound compared to hysteroscopy was significantly lower for these pathologies.