The value of sonohysterograpy in the diagnosis of abnormal uterine bleeding

Purpose: The aim of study was to evaluate the value of transvaginal sonohysterography in the diagnosis of endometrial, submucosal and intracavitary lesions in patients with abnormal uterine bleeding. Methods: This was a prospective case controlled study. Sonohysterography was performed in 50 women (aged 33–64 years) with abnormal uterine bleeding in whom transvaginal sonography suggested an increased endometrial thickness or poorly defined endometrium. Sterile saline solution (10–30 mL) was injected into the endometrial cavity under direct ultrasonographic visualization. Once the endometrial cavity was expanded, the presence of polyps or submucous myomas and the anterior and posterior endometrial thickness was assessed. Following that the endometrial biopsy was performed. The 26 of 50 patients underwent hysterectomy. Results: In sonohysterographic examination, 11 patients had submucous myomas, six patients had endometrial polyps and the others had diffuse or focal increased endometrial thickness. The results of sonohysterography and transvaginal ultrasonography differed significantly ( x 2 = 11, P < 0.05). The results of sonohysterography and endometrial biopsy differed significantly ( x 2 = 11, P 0.05). Sensitivity and specificity for sonohysterography were 85 and 100% and positive and negative predictive values were 100 and 85%, respectively. Conclusion: Sonohysterography is highly accurate method which allows differentiation of intracavitary, endometrial and submucosal lesions in patients with abnormal uterine bleeding.