Comparison of transvaginal sonography with hysteroscopy in evaluation of uterine cavity anomalies for female Nigerian patients

Abstract

Introduction: Transvaginal sonography (TVS) and hysteroscopy are useful in investigating causes of intrauterine pathologies. Aim: To compare the diagnostic yield of TVS with hysteroscopy for the evaluation of uterine cavity anomalies in female Nigerian patients. Materials and Methods: This is a cohort study of patients referred with infertility and abnormal uterine bleeding that were consecutively evaluated with TVS by a radiologist and confirmed by hysteroscopy at a multi-disciplinary endoscopy centre in Port Harcourt metropolis, Nigeria. Study period was from June 2014 to November 2019. Variables collated were sociodemographic, radiological, and endoscopic findings, sensitivity, specificity, and predictive values. Statistical analysis was with SPSS version 20. Results: A total of 99 patients had hysteroscopy but 52 patients included in study. The age of patients ranged from 25 – 56 years; mean age of 39.4 ± 6.0 years. The sensitivity and specificity of TVS for detection of intracavitary uterine anomalies were 78.7% and 100% respectively. The positive and negative predictive values were 100% and 33.3% respectively. There was additional detection of intramural ± subserosa myoma by TVS alone in 28(53.8%) patients and ovarian cysts in 5(9.6%) patients. Conclusion: TVS is an effective screening tool for preoperative triage of women with infertility and abnormal uterine bleeding requiring therapeutic intervention for intracavitary uterine anomalies. Hysteroscopy remains the gold standard for diagnosis of endometrial pathologies.