Objective-To evaluate and compare the diagnostic accuracy of hysteroscopy and transvaginal sonography in patients with abnormal uterine bleeding, postmenopausal bleeding and infertility.
Design-Prospective comparative study
Setting-Endoscopic gynecology department of PSRI hospital, new delhi.
Patients-On the basis of inclusion and exclusion criteria, 110 patients of abnormal uterine bleeding, post menopausal bleeding and infertility attending gynecology opd in our hospital were selected for study.
Intervention-Transvaginal sonography and hysteroscopy both were performed on these patients with abnormal uterine bleeding, post menopausal bleeding and infertility. A biopsy was obtained from all patients during hysteroscopy. Main outcome measured - Sensitivity, specificity, positive predictive value, negative predictive value, accuracy of both diagnostic method were calculated and compared.
Result-Hysteroscopy had higher sensitivity in diagnosing intrauterine pathologies like polyp, submucosal fibroid (0,1,2), intrauterine adhesions, and retained products of conceptions. Trans vaginal sonography had high sensitivity and positive predictive value in diagnosis of intramural and subserosal fibroid (4- 7). The combination of hysteroscopy and transvaginal sonography had higher predictive value in diagnosis of adenomyosis.
Conclusion-Hysteroscopy is a better diagnostic tool for the diagnosis of endometrial polyp, submucosal, intramural fibroid (o,1,2,3), retained products of conception, intrauterine adhesions, septate uterus and bony chips inside the uterine cavity. Whereas intramural and subserosal fibroid (4,5,6,7) are best diagnosed with transvaginal sonography. Although adenomyosis is best visualized with 3D transvaginal sonography, hysteroscopic features also support the diagnosis.
Impact Factor
2022: 6.012
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