Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies
- 24 February 2005
- journal article
- research article
- Published by Wiley in Australian and New Zealand Journal of Obstetrics and Gynaecology
- Vol. 45 (1), 30-35
- https://doi.org/10.1111/j.1479-828x.2005.00336.x
Abstract
To determine whether performing transvaginal sonography (TVS) and saline infusion sonography (SIS) before hysteroscopy could reduce the number of diagnostic hysteroscopies performed for the evaluation of uterine cavity abnormalities. Two hundred and twenty three women with suspected uterine cavity abnormalities were prospectively evaluated by TVS, SIS and hysteroscopy, and had histological evaluation of the endometrium with hysteroscopic biopsy or dilatation and curettage (D&C). One hundred and sixty five patients (74%) were premenopausal and 58 patients (26%) were postmenopausal. The positive predictive value (PPV) for endometrial polyps was 69% for TVS, 78% for SIS and 81% for hysteroscopy in premenopausal patients. In the postmenopausal group, TVS and SIS could detect only 24% of endometrial polyps, whereas 70% were diagnosed by hysteroscopy. The PPV for submucous fibroids was 47% for TVS, 81% for SIS and 77% for hysteroscopy in the premenopausal group. In premenopausal patients, SIS and hysteroscopy are equally accurate in the diagnosis of endometrial polyps and submucous fibroids. Hysteroscopy is the most accurate test for polypoid lesions in the postmenopausal group. Performing TVS, SIS and D&C could reduce the number of diagnostic hysteroscopies performed for the evaluation of uterine cavity abnormalities by 71.5% in premenopausal patients. However, this rate decreases to 40% in the postmenopausal group.Keywords
This publication has 23 references indexed in Scilit:
- Saline contrast hysterosonography in abnormal uterine bleeding: a systematic review and meta‐analysisBJOG: An International Journal of Obstetrics and Gynaecology, 2003
- Pregnancy rates after hysteroscopic polypectomy and myomectomy in infertile womenObstetrics & Gynecology, 1999
- Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleedingAmerican Journal of Obstetrics and Gynecology, 1996
- A prospective comparison of transvaginal ultrasonography and diagnostic hysteroscopy in the evaluation of patients with abnormal uterine bleeding: Clinical implicationsAmerican Journal of Obstetrics and Gynecology, 1995
- Sonohysterography for distinguishing endometrial thickening from endometrial polyps in postmenopausal bleedingUltrasound in Obstetrics & Gynecology, 1994
- Transvaginal sonography and hysteroscopy in postmenopausal bleedingActa Obstetricia et Gynecologica Scandinavica, 1994
- Sonohysterography versus Hysteroscopy in the Diagnosis of Endouterine PolypsGynecologic and Obstetric Investigation, 1994
- Transvaginal Hysterosonography for Differential Diagnosis between Submucous and Intramural MyomaGynecologic and Obstetric Investigation, 1993
- The uterus: A new look with transvaginal sonographyJournal of Clinical Ultrasound, 1990
- Sonographic investigation of the uterus during artificial uterine cavity distentionJournal of Clinical Ultrasound, 1987