Evaluation of intrauterine disorders by hysteroscopy and transvaginal sonography

Abstract

Objective To compare the diagnostic accuracy of transvaginal sonography and hysteroscopy for intrauterine disorders. Design 300 patients were investigated by transvaginal sonography for abnormal vaginal bleeding. Of these, 112 had subsequent hysteroscopic examination and then had concomitant surgery. Results The accuracy of findings at hysteroscopy and transvaginal ultrasonography were compared with the histopathological and surgical results as the gold standard diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography were 77.4%, 50%, 49% and 78.1%, respectively, for transvaginal ultrasonography, and those of hysteroscopy were 92.3%, 97.4%, 97.3% and 92.6% respectively. Conclusion Hysteroscopy is quick, well tolerated, and more accurate in detecting intrauterine pathology than transvaginal ultrasonography. The uterine cavity can be observed directly under hysteroscopy and this examination can provide a high diagnostic accuracy. Biopsy and treatment can be done at the time of the hysteroscopic examination. Thus it is preferable to transvaginal ultrasound examination.

Diagnostic accuracy of liquid‐based endometrial cytology in the evaluation of endometrial pathology in postmenopausal women

“…Only in the range between 0.07% and 0.6% are patients asymptomatic. [3][4][5] In about 10% of cases AUB is associated with endometrial cancer, but it can be caused by many other conditions, such as polyps, myomas, hormonal dysfunction and, most commonly in postmenopausal women, atrophy. 6,7 Endometrial pathology can be identified using several methods, such as transvaginal ultrasound with or without Color-Doppler and 3-D analysis, hysteroscopy and endometrial biopsy, sonohysterography and the presence of endometrial cells in cervical cytology slides.…”

The efficacy of hysteroscopy in diagnosis and treatment of endometrial pathology

“…Transvaginal ultrasound fails to differentiate intrauterine abnormalities (i.e., myomas, polyps, hyperplasia, etc. ), so having a low diagnostic sensitivity ranging from 76% to 96% [4,5]. Visualization of the endometrial echo or endomyometrial complex may also be limited by the uterine position, myometrial lesions that distort endometrial line, and by the resolution of the imaging technology.…”

Footprint lesion: a mirror image of an endometrial polyp

“…Their incidence varies depending upon the population under study and can range between 7.8-34.9%. 6,7 Intrauterine pathologies are diagnosed by transvaginal ultrasound as a first line investigation. However, its sensitivity ranges between 76% to 96%.…”