Open AccessTransvaginal ultrasonography sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding
Author(s) -
Krampl Elisabeth,
Bourne Tom,
HurlenSolbakken Heidi,
Istre Olav
Publication year - 2001
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1034/j.1600-0412.2001.800706.x
Subject(s) - medicine , hysteroscopy , uterine cavity , outpatient clinic , transvaginal ultrasonography , ultrasonography , radiology , prospective cohort study , uterine bleeding , metrorrhagia , endometrial hyperplasia , gynecology , obstetrics , endometrium , surgery , uterus , population , environmental health , family planning , research methodology
Objective. To evaluate the diagnostic accuracy of transvaginal ultrasonography, sonohysterography and hysteroscopy in patients presenting with abnormal uterine bleeding. Design. Prospective, blind, comparative study. Setting. Outpatient clinic and day surgery unit of a district hospital specializing in operative hysteroscopy. Patients. One hundred consecutive patients referred with abnormal uterine bleeding (AUB). Interventions. Transvaginal ultrasonography and sonohysterography were performed in the outpatient clinic. Within 1 week, all patients underwent operative hysteroscopy. Main outcome measures. All diagnoses established by transvaginal ultrasonography, and sonohysterography were compared to the appearance of the cavity using hysteroscopy as well as the histological diagnosis from removed tissues. Results. In 88 patients information suitable for analysis was obtained by all methods. The detection rate of focal intrauterine pathology using sonohysterography was (94.1%), but was significantly lower with transvaginal ultrasonography (23.5%). In about 75% of all cases none of the methods used was able to correctly detect endometrial hyperplasia. Conclusions. Sonohysterography was significantly better than transvaginal ultrasonography in detecting focal intrauterine pathology. Visual examination at operative hysteroscopy yielded no additional information to the detection or exclusion of focal lesions than was obtained at outpatient sonohysterography. All methods performed equally in assessing endometrial pathology. We conclude that sonohysterography may replace diagnostic hysteroscopy in many patients with AUB.