A PROSPECTIVE STUDY ON ROLE OF HYSTEROSCOPY VS. TRANSVAGINAL SONOGRAPHY IN DIAGNOSIS OF ABNORMAL UTERINE BLEEDING

AIMS AND OBJECTIVES: To study the demographic pattern of the patients and to evaluate causes of abnormal uterine bleeding in different menstrual phases using transvaginal sonography and diagnostic hysteroscopy. Evaluation of the validity of transvaginal sonography and hysteroscopy in various menstrual abnormalities and intrauterine pathologies. MATERIAL AND METHODS: Total 60 patients were selected with complaint of abnormal uterine bleeding who were in reproductive, premenopausal and postmenopausal phase of life and were grouped similarly. All patients were subjected for transvaginal sonography followed by hysteroscopy. RESULTS: Analysis of 60 cases were done, 21 (35%) cases were normal and 39 (65%) were having different uterine pathologies according to transvaginal sonography whereas 13 (21.66%) were normal and 47 (78.34%) were having uterine pathology as per hysteroscopy. In this study hysteroscopy was superior to TVS in detecting endometrial polyp and hyperplasia with sensitivity (100%), specificity (97.8%), positive predictive value (92.8%) and negative predictive value (100%) for polyp and 100%, 98.04%, 90% and 100% respectively for hyperplasia. Hysteroscopy shows 100% validity for submucous fibroid. TVS has better sensitivity (100%), specificity (98.2%) and NPV (100%) than hysteroscopy for detecting adenomyosis. TVS is superior to hysteroscopy in investigating endometrial carcinoma with 100%. Sensitivity, Specificity, PPV and NPV against hysteroscopic value of 66.6%, 100%, 100% and 98.2% respectively. Hysteroscopy has higher sensitivity (92.0%) NPV (69.2%) whereas TVS has higher specificity (100%), PPV (100%) in diagnosis of AUB. CONCLUSION: Diagnostic hysteroscopy and transvaginal sonography are complimentary to each other in management of patients with abnormal uterine bleeding.