This prospective observational study aimed to assess the role of transvaginal ultrasound (TVS) in diagnosing the cause of abnormal uterine bleeding (AUB) and characterizing benign and malignant lesions. 130 patients were included and underwent TVS and histopathological examination. TVS showed sensitivity of 59%, specificity of 93%, positive predictive value of 81%, negative predictive value of 82%, and accuracy of 58% for diagnosing malignant lesions. The study provided TVS imaging features for early identification, characterization, and extent of uterine pathologies, as well as relevant information for clinicians to make reasonable decisions. TVS is a good primary imaging modality due to its non-invasiveness, low cost, and wide availability.
