P30.17: Should be 3D SIS performed prior to hysteroscopy in patients with endometrial tumors?

Asessment of transvaginal 3D multislice saline infusion sonohysterography for preoperative evaluation of the endometrial cavity changes before further surgical procedures. In this study 45 patients with suspected endometrial pathology were included. 17 patients with evident pathology on transvaginal 3D multislice ultrasound were not scheduled for further SIS procedure. The remaining 28 patients underwent the additional 3D multislice SIS procedure in order to evaluate the uterine cavity. Once we were assured that the catheter was in the correct position warm saline was introduced into the uterine cavity and during this procedure 3D multislice transvaginal scans of the uterus were performed after distension of the uterine walls. Scans were performed in sagital direction and then, after additional injection of saline, in transversal direction of the uterus. Mean patient's age was 38,7 years. In two patients 3D multislice SIS revealed normal endometrium and uterine cavity. Single polyp was detected in 15 patients. Polyp diameter ranged from 4 mm up to 25 mm. Multiple endometrial polyps were detected in two patients. Endometrial polyposis was detected in 4 patients. In two patients endometrial adhesions were confirmed. In three patients submucous myomas were confirmed. Definitive hystopathological results confirmed endometrial polyps in 21 case. In one patienet Adenomyosis was found in the polyp tissue. Intracavitary fibroids were confirmed in two cases, and also submucous myomas in 2 cases. The 3D SIS is not time consuming, causes minimal discomfort to the patient and can be performed in office settings. This procedure allows not only 3D reconstruction of the uterus and detected endometrial, intracavitary and submucosal pathology, but also their association with the uterine wall and position in the uterine cavity. 3D multislice SIS enables correct measurement of the size and volume of diagnosed tumors. The obtained images can be helpful in planning of the hysteroscopic operative treatment and removal of diagnosed tumors.