Background: Abnormal uterine bleeding (AUB) is the most common gynecological problems that many factors are involved in its creation. Two common methods used to diagnose uterine lesions are vaginal ultraultrasonography and hysteroscopy. The aim of this study was to evaluate the diagnostic value of transvaginal ultraultrasonography and hysteroscopy in the diagnosis of intrauterine lesions leading to the AUB.

Methods: A cross-sectional study was performed on 203 premenopausal post-menopausal women with complaints of abnormal uterine bleeding. A transvaginal ultraultrasonography was performed from the eligible subjects. In the second visit, a hysteroscopy was done and during the hysteroscopy procedure an endometrial biopsy was obtained from all the women. Pathology was considered as the gold standard and sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods using the Cat maker software.

Results: The mean age of 203 patients who precipitated in this study was 43.1±2.7.  Leiomyoma was the most common leading cause of abnormal uterine bleeding (36%). Sensitivity, specificity, positive predictive value and negative predictive value of ultraultrasonography in the diagnosis of intrauterine lesions were 74.2%, 49.75%, 71.9% 54.3%, respectively and for hysteroscopy were 91.67%, 86%, 85.9% and 88.7, respectively.

Conclusion: Hysteroscopy results were more consistent with the results of pathology and it was more accurate than transvaginal ultraultrasonography in the diagnosis of intrauterine lesions leading to the AUB.