Abnormal uterine bleeding: imaging techniques for evaluation of the uterine cavity and endometrium before minimally invasive surgery--the case for transvaginal ultrasonography.

Transvaginal ultrasound has been utilized for first line evaluation of abnormal uterine bleeding since its development in the early 1980's. The benefits and diagnostic effectiveness of transvaginal ultrasound in assessing the uterus, unlike hysteroscopy, extends to the complete pelvis. The ease of application, patient acceptance, and immediacy of results are rapidly apparent. Comparisons with hysteroscopic evaluation are discussed. While tissue diagnosis is still the gold standard, transvaginal sonography lets one know what surgical procedure to plan for from hysteroscopy to Endoscopy or laparotomy, including when no further surgical evaluation is necessary.