Comparative Diagnostic Accuracy of Multimodal Imaging and Office-Based Procedures for Early Detection and Management of Common Benign Gynecological Disorders
Keywords:
endometriosis, uterine fibroids, abnormal uterine bleeding, transvaginal ultrasound, hysteroscopy, adenomyosis, diagnostic accuracyAbstract
Background: Benign gynecological disorders—including endometriosis, uterine fibroids, adenomyosis, and abnormal uterine bleeding—represent a substantial global burden affecting reproductive-age and perimenopausal women. Timely and accurate diagnosis is critical for appropriate clinical management and preservation of fertility. Methods: A comparative observational study was conducted among 1,248 women presenting with gynecological complaints at two tertiary referral centers. Seven diagnostic modalities were evaluated against histopathological reference standards. Sensitivity, specificity, and clinical utility were assessed. Results: Office hysteroscopy demonstrated the highest diagnostic accuracy (sensitivity 94–99%, specificity 96–99%), while transvaginal ultrasound remained the optimal first-line tool due to cost-effectiveness and immediacy. Endometriosis was most commonly associated with pelvic pain (41.5%), fibroids with abnormal bleeding (52.3%), and adenomyosis with postmenopausal bleeding (13.2%). Conclusion: A structured multimodal diagnostic algorithm significantly improves detection rates and guides tailored treatment. Integration of office-based hysteroscopy with ultrasound represents the most cost-effective pathway for benign gynecological conditions.
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