Objective: To assess the accuracy of 3D Transvaginal sonar (TVS) in the diagnosis of endometrial hyperplasia in women with premenopausal uterine bleeding.

Methods: Fifty-five women with premenopausal bleeding were recruited from outpatient gynecology clinic in Zagazig University Hospitals, and Agial Fertility Center. The study was conducted from January 2014 till January 2017 The endometrial volume obtained by 3D TVS and results of the histopathological examination of the endometrial tissue were evaluated to assess the cut off value of endometrial volume for diagnosis of endometrial hyperplasia and carcinoma.

Results: 55 premenopausal women presented by abnormal uterine bleeding were included in the study. Women with benign endometrial pathology were 32 (58.2%), which included atrophic and disordered proliferative endometrium. Women with endometrial hyperplasia were 21 which included hyperplastic polyp, Simple Endometrial hyperplasia without atypia and others with atypia and complex endometrial hyperplasia while endometrial carcinoma was found in 2 patients.

Conclusion: Endometrial hyperplasia is the commonest observed endometrial abnormality in premenopausal patients with abnormal uterine bleeding. Even though histopathological examination of the endometrium is the gold standard for diagnosis or exclusion of endometrial pathology, 3D TVS are reasonably accurate, helpful & non-invasive tool for assessing the endometrium.