Comparison of Transvaginal Ultrasonography and Hysteroscopy in the Diagnosis of Endometrial Polyp in Abnormal Vaginal Bleeding

Background and objectives: Various methods and devices are currently applicable to diagnose endometrial polyps with different outcomes. This study aimed to compare the efficacy of trans-vaginal ultra-sonography in relation to the rigid hysteroscopy in the diagnosis of endometrial polyps in patients with abnormal vaginal bleeding. Methods: This cross-sectional study enrolled 70 female patients with endometrial polyps at Sulaimani Maternity Teaching Hospital, Iraq, from May 01, 2022 to May 01, 2023. A well-designed questionnaire including the patient's age, gender, residency, educational level, parity, and presentation symptoms. Then, transvaginal ultrasonography and rigid hysteroscopy were done for all enrolled patients to determine the type of endometrial polyp. Results: Most patients (57.14%) were aged 30-40 years, from suburban regions (47%), graduated from preparatory school (47.14%), multipara (91.43%) and had heavy vaginal bleeding (72.86%). Upon transvaginal ultrasonography and rigid hysteroscopy examinations, most females were diagnosed to have simple endometrial polyp (84.21% and 86.84%, respectively), followed by endometrial hyperplasia with atypia (60% and 100, respectively), then pedunculated leiomyoma (70% and 90%, respectively), and benign endometrial polyps (57.14% and 71.42%, respectively). There was no significant difference (p=0.19) between transvaginal ultrasonography and rigid hysteroscopy in sensitivity and specificity for diagnosing simple endometrial polyps. Conclusions: Transvaginal ultrasonography and rigid hysteroscopy methods are preferred to diagnose endometrial polyps; in which rigid hysteroscopy is preferable for endometrial hyperplasia with atypia, and transvaginal ultrasonography is for benign endometrial polyps.