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VOLUME 8 , ISSUE 1 ( January-June, 2020 ) > List of Articles

Original Article

Comparative Study of the Diagnostic Accuracy of Transvaginal Sonography vs Hysteroscopy in Abnormal Uterine Bleeding

Suchithra Reddy, Sheela Jayaprakash

Citation Information : Reddy S, Jayaprakash S. Comparative Study of the Diagnostic Accuracy of Transvaginal Sonography vs Hysteroscopy in Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2020; 8 (1):30-33.

DOI: 10.5005/jp-journals-10032-1201

License: CC BY-NC 4.0

Published Online: 01-04-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Introduction: Abnormal uterine bleeding (AUB) is one of the most common symptoms with which patients visit to a gynecologist. Abnormal uterine bleeding is responsible for more than one-third of gynecological consultations and nearly two-thirds of hysterectomies.1 Aims and objectives: • To evaluate the accuracy of hysteroscopy in diagnosing various conditions causing AUB. • To compare hysteroscopic findings with transvaginal sonography (TVS) findings. Materials and methods: A prospective study was conducted on 100 women fitting into the inclusion criteria in the Department of Obstetrics and Gynaecology at Vydehi Institute of Medical Sciences and Research Center, Bengaluru. Detailed history, clinical examination, TVS, hysteroscopy, and preoperative investigations were carried out and results were correlated. Results: In the present study, majority of the patients were in perimenopausal age group. Transvaginal sonography has showed 12% and 8.3% sensitivity in detecting polyp and submucosal fibroid when compared to hysteroscopy. Transvaginal sonography showed poor correlation with hysteroscopic findings for intracavitary pathology. Intrauterine adhesions were missed by TVS in three cases which were diagnosed by hysteroscopy. Conclusion: There is an increased incidence of intracavitary uterine pathology in patients who present with AUB. The poor sensitivity of TVS in detecting intrauterine pathology urges us to suggest that hysteroscopy can be utilized as a first-line investigation in these patients. As many cases with intracavitary lesions and carcinoma were not diagnosed by TVS, the need for number of diagnostic hysteroscopies (invasive) could not be minimized by TVS (noninvasive) examinations. Hysteroscopy can be used not only for therapeutic purpose but also for diagnostic tool in cases who present with AUB, clinically enlarged uterus, and significant anemia.

  1. Lasmar RB, Dias R, Barrozo PRM, et al., Prevalence of hysteroscopic findings and histological diagnosis in patients with abnormal uterine bleeding. Fertil Steril [internet]. 2008 Jun [cited 2014 Oct 26]: 1803-7. Available from:
  2. Emanuel MH, Verdel MJ, Wamsteker K, et al. A prospective comparison of TVS and diagnostics hysteroscopy in the evaluation of patients with abnormal uterine bleeding. Clinical implications. Am J Obstet Gynaecol 1995;172(4):547–552. DOI: 10.1016/0002-9378(95)90571-5.
  3. Coulter A, Bradlow J, Agass M, et al. Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records. Br J Obstet Gynaecol 1991;98(8):789–796. DOI: 10.1111/j.1471-0528.1991.tb13484.x.
  4. Towbin N, Gviazada I, March C. Office hysteroscopy versus transvaginal ultrasonography in evaluation of patients with excessive uterine bleeding. Am J Obstet gynaecol 1996;174(6):1678–1682. DOI: 10.1016/S0002-9378(96)70196-5.
  5. Sheth SS, Nehrukar NM, Mangeskar P. Hysteroscopy in abnormal bleeding. J Obstet Gynaec India 1990;40(3):451–454.
  6. Veena BT, Shivalingaiah N. Role of transvaginal sonography and diagnostic hysteroscopy in abnormal uterine bleeding. J Clin Diagnos Res 2014;8(12):6–8.
  7. Vitner D, Filmer S, Goldstein I, et al. Comparison between ultrasonography and hysteroscopy in the diagnosis of uterine bleeding. Eur J Obstet Gynaecol Reproduct Biol 2013;171(1):143–145. DOI: 10.1016/j.ejogrb.2013.08.024.
  8. Farquhar C, Ekeroma A, Furness S, et al. A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women. Acta Obstet Gynecol Scand 2003;82(6):483. DOI: 10.1034/j.1600-0412.2003.00191.x.
  9. Dijkhuizen FPHLZ, de Veries LD, Mol BMJ, et al. Comparison of trans vaginal ultrasonography and saline infusion sonography for detection of intracavitary abnormalities in premenopausal women. Ultrasound Obstet Gynecol 2000;15(5):372. DOI: 10.1046/j.1469-0705.2000.00115.x.
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