EP15.21: The value of saline infusion sonohysterography (SIS) in diagnosing uterine cavity mass in subfertile women

To investigate the sensitivity, specificity, positive and negative predictive values of SIS in diagnosing uterine mass in subfertile women. This is a prospective diagnostic test. Eligible patients were subfertile women having indications for laparoscopy for tubal factors, ovarian tumours, endometrioma, and uterine cavity mass. SIS was performed within a month prior to the operating day and SIS report was blinded to surgeons. Gold standard for diagnosis of abnormal uterine mass was histopathology or hysteroscopy. From 7/2015 to 3/2016, a total of 433 patients was enrolled to the study. The prevalence of patients with uterine cavity mass was 49.6%, in which, 45.7% had endometrial polyp, and 3.9% had submucous fibroid. The sensitivity and specificity of SIS in diagnosing endometrial polyp were 87% and 85%, and submucous fibroid were 78% and 98%. Multivariate regression analysis showed that size of endometrial polyp was an independent factor that predicted the accuracy of SIS in diagnosing uterine cavity mass. SIS has a good value in diagnosing uterine cavity mass with the sensitivity and specificity of 87% and 85% for diagnosing endometrial polyp and 78% and 98% for submucous fibroid. Obtaining SIS prior to hysteroscopy will provide better information for laparoscopic surgeons to establish a tackling plan and for clinicians to do proper preoperative counselling to patients about the management that may happen during the operation.