The place of transvagınal ultrasonography saline infusion sonohysterography and hysteroscopy in the diagnosis of abnormal uterine bleedings

This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women.

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Does the addition of saline infusion sonohysterography to transvaginal ultrasonography prevent unnecessary hysteroscopy in premenopausal women with abnormal uterine bleeding?

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/ajo.12490 ◽

2016 ◽

Vol 56 (4) ◽

pp. 432-435 ◽

Cited By ~ 1

Author(s):

John Short ◽

Benjamin Sharp ◽

Nikki Elliot ◽

Rachael McEwing ◽

Graham McGeoch ◽

...

Keyword(s):

Premenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Saline Infusion Sonohysterography

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Endometrial Evaluation by Transvaginal Ultrasonography Saline Infusion Sonohysterography, Hysteroscopy versus Endometrial Office Bipsy in Perimenopausal Bleeding: A Comparative Study

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2020.1080103 ◽

2020 ◽

Vol 10 (08) ◽

pp. 1093-1106

Author(s):

Mohamed Kamal ◽

Almandouh H. Bosilah

Keyword(s):

Comparative Study ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Saline Infusion Sonohysterography

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Saline infusion sonohysterography is required for the initial workup of infertility

10.26226/morressier.573c1513d462b80296c987ba ◽

2016 ◽

Author(s):

Katy Shlush

Keyword(s):

Saline Infusion ◽

Saline Infusion Sonohysterography

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Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.06.10240 ◽

2020 ◽

Vol 103 (6) ◽

pp. 585-593

Keyword(s):

Predictive Value ◽

Final Diagnosis ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Histopathological Diagnosis ◽

Endometrial Polyps ◽

Saline Infusion Sonography ◽

Submucous Myoma ◽

Kappa Value ◽

Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

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