The short-term clinical outcomes after saline infusion sonohysterography in women with postmenopausal bleeding1

Kenneth Meng, Meng K, Branam JD, Jill D. Branam, Hanh V. Nghiem, Nghiem HV, Carlos RC, Ruth C. Carlos
Academic radiology · 2005 · vol. 12(2) , pp. 136–141 · doi:10.1016/j.acra.2004.11.028 · PMID:15721589 · W1965666119
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Saline infusion sonohysterography in women with postmenopausal bleeding revealed abnormalities in 80% of cases, leading to more aggressive subsequent diagnostic or treatment procedures compared to negative exams.

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Abstract

Rationale and objectiveTo describe the short-term clinical outcomes of women with postmenopausal bleeding (PMB) who underwent saline-infused sonohysterography (SIS) and the impact of SIS results on clinical management.Materials and methodsA retrospective review of the Radiology Information Systems database identified 786 women who underwent SIS between February 1998 and October 2002. Of this group, 144 women (mean age, 60; range, 42-83) presented with PMB. The following clinical data were extracted from the electronic medical record: date of birth, hormone replacement therapy (HRT) status, SIS results, and clinical management before and after the SIS procedure. We categorized post-SIS clinical management into three categories: additional diagnostic or therapeutic procedure performed; HRT change or addition; or no change in clinical management. Between-group comparisons were performed using a chi2 test.ResultsOf the 144 women with postmenopausal bleeding who underwent SIS, 119 (82.6%) successfully completed the SIS. Eighty women (67.2%) had a positive SIS exam. Abnormalities detected including polyps (n = 42); submucosal fibroids (n = 6); endometrial thickening (n = 8); a combination of 2 or more of the above (n = 7), or other abnormalities (debris, adenomyosis, or indeterminate findings, n = 17). Of the women with a positive SIS exam, 58% received subsequent diagnostic/therapeutic procedures compared to 5% of women who had a negative SIS (P < 0.001). Conversely, 59% of women with a negative SIS had no change in clinical management compared to 17.5% who had a positive SIS (P < 0.001).ConclusionThe trend in short-term clinical management is to pursue more aggressive subsequent diagnostic or treatment procedures if findings are positive on SIS. A negative SIS exam was associated with more conservative management.

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MeSH descriptors

Endosonography Outcome Assessment, Health Care Postmenopause Sodium Chloride Uterine Hemorrhage Adult Aged Aged, 80 and over Chi-Square Distribution Endometrium Endometrium Endometrium Endosonography Estrogen Replacement Therapy Estrogen Replacement Therapy Female Humans Leiomyoma Leiomyoma Middle Aged

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