Role of Hysteroscopy in Abnormal Uterine Bleeding

Background Abnormal uterine bleeding (AUB) accounts for 33 % of female patients referred to gynaecologists. Common causes of AUB include endometrial polyps, endometrial hyperplasia, submucous fibroids and anovulation. Accurate diagnosis of the cause of AUB can reduce the frequency of hysterectomy. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Methods 60 female patients with AUB were enrolled in the study. Each patient was subjected to TVS where uterine cavity was studied in detail and hysteroscopy under anaesthesia using saline as distension medium. Sensitivity, specificity and predictive value of TVS as compared to hysteroscopy were calculated. Results Menorrhagia was the commonest presenting symptom in the study population (56 %). By comparing the hysteroscopy results with TVUS we found that TVUS has significantly low sensitivity (57 %) but comparable specificity (100 %) in diagnosing intrauterine pathology like endometrial polyp and submucous fibroid, lesser specificity (85 %) in diagnosing endometrial hyperplasia than hysteroscopy. Conclusion TVS is recommended as first line investigation in AUB. Hysteroscopy is recommended gold standard for intra cavitatory pathologies.