Comparison of transvaginal sonography with hysteroscopy and correlation with histopathological report in case of abnormal uterine bleeding

Abstract

Background: Abnormal uterine bleeding (AUB) is change in frequency of menses, duration of flow or amount of blood loss. The objectives of the present study were to determine and compare the diagnostic accuracy of TVUS (Transvaginal ultrasonogrphy) with hysteroscopy for diagnosis of endometrial and intramyometrial pathology in case of abnormal uterine bleeding, to study the correlation with histopathological report of endometrial biopsyMethods: It was a prospective comparative study. 200 cases of AUB were selected from June 2010 to May 2012 attending Gynaecology OPD in tertiary care level public sector teaching hospital at Mumbai, meeting the selection criteria were enrolled into the study. Complete history, detail general, systemic and local examination was performed for all patients. Two-dimensional transvaginal ultrasonography was performed to see for endometrial or intramyometrial pathology. Endometrial thickness was noted for all patients. Hysteroscopy and D&C was performed within 48 hours of ultrasonography. After hysteroscopy, curettage was performed and sent for histopathological examination.Results: TVUS detected, 19 polyps (9.5%) and 81 myomas. It was able to differentiate these myomas as 64 interstitials (32%) and 17 submucous (8.5%) hysteroscopy detected 26 submucous myomas (13%), 31 polyps (15.5%), endometrial hyperplasia detected by TVUS, 19 in premenopausal and 06 in postmenopausal age group. Hysteroscopy detected 24 in premenopausal and 06 in post-menopausal age group. Histopathology of endometrial biopsy it came positive for 13 in premenopausal and 08 in postmenopausal age group. Two cases of CA endometrium were diagnosed on HPE out of which one was diagnosed by TVUS and same was diagnosed by hysteroscopy. Conclusions: TVUS has significantly lower sensitivity but comparable specificity with hysteroscopy in diagnosing endometrial polyp and submucous fibroid, comparable sensitivity and specificity in diagnosing endometrial hyperplasia, equivalent sensitivity and specificity in diagnosing endometrial carcinoma, accuracy of TVUS for detecting pathology in AUB is comparable to hysteroscopy, suitable for developing countries as first diagnostic step for AUB.

Vaginal Three-Dimensional Ultrasound and Chromohysteroscopy for Endometrial Evaluation in Cases of Failed Intracytoplasmic Sperm Injection

“…As regard efficacy of TVUS in diagnosing endometrial pathology Maiti G et al found that Sensitivity and specificity of TVUS in diagnosing endometrial polyp was 57.5%, 100% respectively, submucous fibroid Sensitivity and specificity was 65.38%, 100% respectively, EHP in postmenopausal bleeding Sensitivity and specificity was 75%, 100 % respectively, endometrium carcinoma sensitivity and specificity was 50%, 100% respectively. Hysteroscopy showed sensitivity and specificity of Hysteroscopy in diagnosing endometrial polyp was 93.3%, 100% respectively, submucous fibroid sensitivity and specificity was 100%, 100% respectively, EHP in postmenopausal bleeding sensitivity and specificity was 75%, 100 % respectively, endometrium carcinoma sensitivity and specificity was 50%, 100% respectively [17].…”

Sensitivity of ultrasound scan and hysteroscopy with histopathological correlation in identifying endometrial pathology for a mixed group of symptomatic and asymptomatic patients

“…7 TVS has significantly lower sensitivity but comparable specificity with hysteroscopy in diagnosing endometrial polyp and submucous fibroid, as reported by Gunadhar Maiti et al reported endometrial polyp was detected in 58% by TVS. 8 In a study including Danish females ages 20 to 74 years, the prevalence of endometrial polyps in pre-and postmenopausal females was 7.6 and 13 percent, respectively. 9…”

Comparative study between diagnostic value of 3D ultrasound versus hysteroscopic finding in patients with perimenopausal bleeding

“…The sensitivity of TVUS for identifying endometrial polyps is 57.57 percent, the specificity is 100 percent, the positive predictive value is 100 percent, and the negative predictive value is 92.26 percent, according to Maiti et al 12 . Hysteroscopy has a sensitivity of 93.93 percent, a specificity of 100 percent, a positive predictive value of 100 percent, and a negative predictive value of 98.80 percent for identifying endometrial polyps.…”

“…Also, the study by Mohammad et al 7 revealed that 22 women (44 percent) had abnormal uterine bleeding, menorrhagia (8 cases (16 percent), metrorrhagia (4 cases (8 percent), menometrorrhagia (5 cases (10 percent), polymenorrhea (2 cases) (4 percent), and postmenopausal bleeding (3 cases) among the bleeding cases (6 percent). additionally, Maiti et al 12 discovered that The most prevalent bleeding pattern was menorrhagia (56 percent), followed by postmenopausal bleeding (15.5%), metrorrhagia (10.5%), polymenorrhagia (10%), and polymenorrhea (10%). (8 percent ).…”