The evaluation of endometrial and myometrial abnormalites trough sonohysterography : a comparative study

Sonohysterography (SHG) is a technique for assessing uterine anomalies and tubal status. This diagnostic procedure is carried out after injecting sterile saline solution into the uterine cavity under continuous sonographic visualisation. \nThis study aimed to evaluate the usefulness of SHG in detecting uterine cavity anomalies and tubal patency in comparison with other methods such as hysteroscopy and transvaginal ultrasonography. \nThis study was performed on 155 infertile patients, aged between 23-44 (median 33.5). All the women underwent hysteroscpy followed by pelvic transvaginal ultrasonography (US) and SHG. US was able to detect 105 uterine pathologies of the 155 uterine abnormalities detected by hysteroscopy (which means 67.0%). Exception made for a single endometrial polyp, sonohysterography was able to detect all the anomalies (98.8%). We performed SHG followed by chromopertubation after six months in 53 patients to compare the diagnostic efficacy in the identification of tubal patency. Tubes resulted patent in 39 (73.3%) and 41 (77%) cases respectivelly after SHG and chromopertubation by laparoscopy. Therefore, SHG results are consistent with those of hysteroscopy and laparoscopy. All the 155 women tolerated the exam, which takes about 15 minutes (SD 5.6 min) in average and the images obtained were all of good quality. Furthermore, SHG revealed its effectiveness in programming to endoscopic surgery. \nSHG allows a precise screening of endometrial and myometrial abnormalities. In the cases of submucosal myomas to be treated by hysteroscopic surgery, it allows to measure exactly the remaining myometrial thickness. SHG can help in the formulation of an immediate diagnosis because it can be performed during an abnormal uterine bleeding. Therefore, sonohysterography is a rapid, easy, cheap and non-invasive method, which is highly recommended for the diagnoses of intrauterine pathologies and tubal status.