Comparison between ultrasound and hysteroscopy in the diagnosis of intra-uterine space-occupying lesion in Tikrit teaching hospital

Abstract

This study evaluates the diagnostic accuracy of two-dimensional transvaginal ultrasound and hysteroscopy in reducing diagnosis of intrauterine lesions. A cross-sectional study at Tikrit Teaching Hospital surveyed 50 women with abnormal uterine bleeding or suspected findings on ultrasonography, including those diagnosed with submucous myoma, endometrial polyps, residual placenta, infertility, recurrent pregnancy loss, and over 16 years old. The exclusion criteria for this statement include the possibility of pregnancy and the presence of pelvic inflammatory disease. Data was collected from women through direct interviews, examining demographics, obstetric history, ultrasound findings, and hysteroscope results. Abnormal findings were resected, and curettage was performed for abnormal uterine bleeding or suspected intrauterine findings. The mean age among cases was 43±12 years. The main complain of then patient were Menorrhagia 17 (34%), intermenstrual bleeding 15 (30%), postmenopausal bleeding 10 (20%), and infertility 8 (16%). The histopathological findings was uterine polyp in 22 (44%), uterine fibroid 4 (8%), Endometrial atrophy 4 (8%), proliferative endometritis 4 (8%), Endometrial hyperplasia 4 (8%), secretory endometritis 2 (4%), others (septet uterus, atypia, endometritis) 6 (12%), and no abnormal finding in 5 (10%). The ultrasound had sensitivity of (84.4%), specificity (80%), false positive (20%), false negative (15.6%), accuracy (84%), positive predictive value (97%), negative predictive value (36.4%). The hysteroscopy had sensitivity (95.6%), specificity (83%), false positive (17%), false negative (4.4%), accuracy (94%), positive predictive value (98%), negative predictive value (71.4%). Transvaginal ultrasonography is a non-invasive, effective first-line investigation for women with vaginal bleeding or suspected endometrial pathology, while hysteroscopy, although sensitive and specific, requires an operating room, anesthesia, and had increasing risk and cost.