scholarly journals To compare the diagnostic accuracy of hysteroscopy with transvaginal sonography in detection of endometrial polyp and endometrial hyperplasia in peri and postmenopausal women with abnormal uterine bleeding

2020 ◽  
Vol 7 (4) ◽  
pp. 498-503
Author(s):  
Surbhi Sharma ◽  
◽  
Anoop Sharma ◽  
Author(s):  
Kushla Pathania ◽  
Surbhi Sharma

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.


Author(s):  
Jaya Choudhary ◽  
Veena Acharya ◽  
Monika Jain

Background: Abnormal uterine bleeding is defined as any deviation from the normal menstrual cycle this include change in regularity, frequency of menses, duration or amount of bleeding during or in between periods. Objective of present study was to evaluate abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women.Methods: This study is conducted on women presenting to the gynecological OPD with complain of abnormal uterine bleeding in perimenopausal age group. A total of 50 patients were subjected to transvaginal sonography and Diagnostic hysteroscopy.Results: On TVS, out of total 50 patients, 50% patient showed normal endometrial finding. 24% Patient showed Endometrial hyperplasia, 14% Endometrial Polyp, 8% Submucosal fibroid, 4% Adenomyosis. On TVS, out of total 50 patient, 50% patient showed normal endometrial finding. 24% Patient showed endometrial hyperplasia, 14% endometrial Polyp, 8% submucosal fibroid, 4% adenomyosis. Out of total 50 patients, 28 (56%) showed normal endometrial finding.20% cases showed endometrial Hyperplasia, 16% showed endometrial Polyp, 8% showed submucosal fibroid. Sensitivity, specificity, PPV, NPV of endometrial hyperplasia – 81.81%, 92.3%, 75%, 94.73% respectively.Conclusions: Transvaginal sonography has a moderate diagnostic accuracy in detecting endometrial hyperplasia and other intrauterine pathology. TVS is safe, acceptable and easily available & is noninvasive. It should be used as 1st line diagnostic tool in patients with AUB in perimenopausal women. Hysteroscopy has important tool in the diagnosis of various endometrial and intrauterine lesions TVS and hysteroscopy should be employed hand in hand in evaluation of AUB.


2012 ◽  
Vol 1 (1) ◽  
pp. 11-13
Author(s):  
Kulsum Haq ◽  
Shabnom Ferdous Chowdhury ◽  
Maksuda Mannan ◽  
Rokshana Ivy ◽  
K Shahneela Tasnim

Objective: The objective of this study is to assess the utility of transvaginal ultrasonography in patients presenting abnormal uterine bleeding Materials and methods: Between July 2000 to December 2000, 50 patients underwent transvaginal sonography (TVS) for abnormal uterine bleeding. All patients had transvaginal sonography before histopathology. On TVS, the sonographic appearance of the endometrium was classified according to the following parameters: normal or abnormal thickness, homogeneous or heterogeneous echogenicity, bulbous contour, discontinuous, or obscured. A comparison was performed between TVS with histopathology. Results: The most common causes for the abnormal uterine bleeding were leiomyoma in TVS (42.0%). Other causes were dysfunctional uterine bleeding (28.0%). adenomyosis (6.0%), endometrial polyp (4.0%), thin atrophic endometrium (8.0%), endometrial hyperplasia (8.0%), and endometrial carcinoma (4.0%). After histopathologic evaluation 40.0% patients had leiomyoma, 24.0% DUB, 10.0% adenomyosis, 8.0% endometrial polyp, 8.0% thin atrophic endometrium, 6.0% endometrial carcinoma and 4.0% endometrial hyperplasia. Comparing the TVS with histopathologic findings, TVS had a sensitivity of 94.3%, specificity of 80.0%. accuracy of 90.0%, PPV of 91.6% and NPV of 85.7%. Conclusion: TVS is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in the diagnosis of uterine pathology responsible for abnormal uterine bleeding. Abbreviation: TVS transvaginal sonography; AUB abnormal uterine bleeding; DUB dysfunctional uterine bleeding, PPV positive predictive value, NPV Negative predictive value. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12168 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.11-13


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.


2021 ◽  
Vol 8 (12) ◽  
pp. 682-687
Author(s):  
Seema Pandey ◽  
Mamta Kumari ◽  
Amrita Chaurasia ◽  
Gyan Prakash

BACKGROUND Abnormal uterine bleeding is an important cause of morbidity in the female population, which can be attributed to several reasons. Trans-vaginal sonography and saline-infusion sonography are the mainstay of diagnosis and govern the further management of this condition. This study was conducted to evaluate the thickness and pattern of endometrium with transvaginal sonography and determine any abnormality in the uterine cavity which can be attributed to saline infusion sonography (SIS) in cases of abnormal uterine bleeding (AUB). METHODS The study was conducted among 122 women with complaints of abnormal uterine bleeding attending Outpatient Department and indoor cases of a tertiary care hospital over a period of twelve months. RESULTS The most common presenting complaint was heavy menstrual bleeding in 27.04 % cases. Maximum (44.26 %) cases had normal finding on transvaginal sonography; most common pathological finding was leiomyoma (22.31 %), and endometrial hyperplasia (15.5 %). More than one third (37.7 %) of patients had no abnormalities on saline infusion sonography; while 62.3 % had one or more pathologies; the most common lesion was fibroid in 25.4 % cases. Normal proliferative and secretary endometrium was found on histopathological examination in 50 % cases, while remaining half cases had one or more pathology, most common pathology detected was endometrial hyperplasia in 25.4 % cases. On trans-vaginal sonography (TVS), 11 cases of endometrial polyp were missed, which were detected after infusion of saline and confirmed by histopathological examination. The diagnostic indices of SIS were superior to TVS in diagnosis of any pathology. Sensitivity of TVS was 86.94 % and SIS was 91.94 %. Specificity of TVS (75.41 %) was greater than SIS (68.33 %). CONCLUSIONS TVS and SIS scanning techniques play a very important role in endometrial disorders in woman with AUB. KEYWORDS SIS, Transvaginal, AUB, Endometrium


2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Anjali Chandra ◽  
Shashibala Arya ◽  
J. K. Goel ◽  
Rajneesh Madhok ◽  
M. Sinha ◽  
...  

<bold>Introduction:</bold> The present study was conducted to evaluate the validity of Transvaginal Sonography (TVS) in perimenopausal women with abnormal uterine bleeding (AUB), validity of saline infusion sonohysterography in perimenopausal women with abnormal uterine bleeding and to compare the diagnostic accuracy of the above mentioned modalities. <bold>Material and Methods:</bold> It was a prospective comparative study of TVS and Saline Infusion Sonohysterography (SIS) in 100 perimenopausal women presenting with AUB. The findings of TVS and SIS was compared with histopathology. <bold>Result:</bold> The sensitivity of TVS for submucosal fibroid, polyp, intramural fibroid and endometrial hyperplasia was found to be 50%,44.44%, 40%, 33.33% respectively while specificity being 88.29%, 95.60%, 88.88%, 95.60% respectively. The sensitivity of SIS for endometrial hyperplasia and submucosal fibroid was found to be same (66.66%) whereas for polyp and intramural fibroid was 55.55% and 50% respectively. Specificity of SIS for polyp, endometrial hyperplasia, intramural fibroid and submucosal fibroid was found to be 98.90%,95.60%,92.2% and 90.42% respectively. Overall sensitivity and specificity of TVS was 79.4% and 75.8 % respectively whereas for SIS is 82.4% and 80.3% respectively. <bold>Conclusion:</bold> SIS is simple, highly sensitive and specific technique to detect intrauterine pathology.


Author(s):  
Vandana R. Saravade ◽  
Shuchi Chaturvedi

Background: Objectives of the study were to study the endometrial patterns in cases of abnormal uterine bleeding (AUB) and anatomical (structural) lesions of uterus using transvaginal sonography (TVS) and endometrial histopathology and to determine the efficacy of TVS.Methods: Cross-section study of 50 perimenopausal age group with AUB in TNMC BYL Nair hospital from Nov 2017 to Nov 2018.Results: AUB was seen 40 to 45 years multiparous women TVS endometrial thickness (ET) T 6-10 mm (46%), ET 11-15 (22%), ET>15 mm (14%), <5 mm in (18%), showed 21 (42%) patients with endometrial hyperplasia on TVS, 12 (24%) simple hyperplasia 4 (8%) complex hyperplasia on histopathology fibroid 8%, adenomyosis 2%. endometrial polyp 6%.Conclusions: Endometrial lining exceeds 10 mm dilation and curettage to be done r/o endometrial hyperplasia, to study the endometrial patterns in cases of abnormal uterine bleeding and anatomical (structural) lesions of uterus using transvaginal sonography and endometrial histopathology.


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