Role of transvaginal ultrasonography in the diagnosis of abnormal uterine bleeding refractory to hormonal therapy

ABSTRACT

TAS and TVS were done simultaneously for 160 cases of abnormal uterine bleeding resistant to hormonal therapy in order to detect the presence of small underlying organic lesions. The results were compared with histopathologic examinations of hysterectomy specimens. The most prevalent lesions on histopathologic study were small leiomyomata <2 cm [68.6%], adenomyosis uteri [39.2%] and endometrial polypi [6.8%]. It was found that the sensitivity of TVS in detection of small leiomyomata was 92.9%, for adenomyosis uteri 65% and for endometrial polypi 85.7%. TAS had a sensitivity of 71.4%, 55% and 71.5% for the same lesions, respectively. The specificity of TVS for leiomyomata was 93.9%, for adenomyosis uteri 96.2% and for endometrial polypi 96.1%, compared with TAS, which showed a specificity of 91%, 65.6% and 85.6% for the same lesions, respectively. It was concluded that TVS had higher sensitivity and specificity compared with TAS in the detection of small underlying organic lesions in cases of abnormal uterine bleeding