Diagnostic Accuracy of Office Hysteroscopy and Three-Dimensional Transvaginal Ultrasonography in Women with Abnormal Uterine Bleeding

Background & Objective: Abnormal Uterine Bleeding (AUB) is a common gynecological complaint with multiple underlying causes, including structural uterine abnormalities. Accurate, minimally invasive diagnostic tools are essential for identifying intrauterine lesions and guiding appropriate management. The present study was conducted with aim to evaluate the diagnostic agreement between office hysteroscopy and three-dimensional transvaginal ultrasonography (۳D TVS) in detecting intrauterine pathology among women presenting with AUB.Materials & Methods: This cross-sectional analytic study was conducted at the Department of Obstetrics and Gynecology, Kasr Al-Ainy Medical Hospital, Cairo University, from June ۲۰۲۱ to April ۲۰۲۳. Eighty women with AUB were evaluated using ۳D TVS followed by office hysteroscopy. Findings from both modalities were recorded and compared for diagnostic correlation. Statistical analysis was performed using IBM SPSS (version ۲۲.۰). P<۰.۰۵ was considered statistically significant.Results: The mean age of participants was ۲۸.۶±۸.۸ years and mean BMI was ۲۹.۹±۶.۳ kg/m². Menorrhagia was the most common bleeding pattern (۵۲.۳%). Office hysteroscopy detected endometrial polyps in ۳۸.۳%, thickened endometrium in ۱۴.۱%, and fibroids in ۱۲.۸%, while ۳D TVS identified polyps in ۲۳.۰%, fibroids in ۱۴.۱%, and adenomyosis in ۱۱.۵%. Diagnostic concordance between the two methods was highest for fibroids (۷۱.۴%) and niches (۱۰۰%), while adenomyosis was detected only by ۳D TVS.Conclusion: Both office hysteroscopy and ۳D TVS are effective for evaluating intrauterine pathology in AUB. Hysteroscopy remains the gold standard for focal lesions, whereas ۳D TVS offers a reliable, noninvasive alternative with added value in detecting myometrial abnormalities.

کلیدواژه ها:

Abnormal uterine bleeding ، Office hysteroscopy ، Three-dimensional transvaginal ultrasonography endometrial polyp ، Fibroid ، Adenomyosis ، Diagnostic Accuracy