Objective: The objective of this study was to compare the efficacy of outpatient and inpatient procedures, and to assess whether hysteroscopy offers any additional benefit when compared to a combination of endometrial biopsy and vaginal ultrasound.
Materials and methods: A total of 50 patients aged >18 years who presented with abnormal uterine bleeding were included in this study. Endometrial aspiration with Pipelle cannula and transvaginal sonography on an outpatient basis and hysteroscopy under anesthesia were performed. The findings of endometrial aspiration and transvaginal sonography were correlated with hysteroscopy-guided biopsy.
Results: There is good sensitivity and negative predictive value of combined EA and TVS (i.e., 84.62% and 88.89%, respectively), while low specificity and positive predictive value (i.e., 51.61% and 42.31%, respectively), which is comparable to hysteroscopy, which has diagnostic accuracy values of sensitivity (84.62%), negative predictive value (90%), positive predictive value (45.83%), and specificity (58.06%).
Conclusion: The combination of TVS and pipelle sampling enhances the diagnostic yield, and hence can be used as first-line investigation as they complement each other, and can be used to triage the patients for hysteroscopy, which is the gold standard and has the added advantage of combining see and treat in skilled hands many cases.