Accuracy of transvaginal ultrasound, saline infusion sonohysterography, and office hysteroscopy in the diagnosis of endometrial polyps (original) (raw)
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Acta Obstetricia et Gynecologica Scandinavica, 2000
Background. The diagnostic accuracy of transvaginal ultrasonography and vaginal sonohysterography in detecting endometrial polyps in women suffering abnormal uterine bleeding are compared. Methods. One hundred and six patients suffering from menometrorrhagia were studied. To detect whether there was endometrial polyp or not, these patients were subjected to transvaginal ultrasonographic examination as well as to sonohysterography. The final diagnosis was established by diagnostic hysteroscopy and its guided biopsy. Results. Transvaginal ultrasonography resulted in false positive and false negative rates of 25% and 36.2% respectively while the figures with sonohysterography were 5.4% and 8% respectively. Combining both techniques further improved such rates to 2.9% and 2.8% respectively but not significantly (p±0.1). The sensitivity and specificity were 64.5%, 75.5% for transvaginal ultrasonography, and 93.1%, 93.9% for sonohysterography (significantly higher: p∞0.001). Conclusions. Sonohysterography is significantly more accurate than transvaginal ultrasonography in the detection of endometrial polyps in cases with abnormal uterine bleeding. Combining both techniques did not significantly improve the diagnostic accuracy. Sonohysterography is an accurate and cost effective method which requires a little skill.
Journal of Obstetrics and Gynaecology Research, 2020
Background: Transvaginal sonography (TVS) and office hysteroscopy are considered essential diagnostic tool for the gynecologic everyday practice. Through the years equipment developments in both techniques along with cumulative experience gained by the gynecologists result in a disunity among clinicians in choosing optimal diagnostic approach with regards to endometrial pathology. Aim: To evaluate the diagnostic accuracy of TVS versus office hysteroscopy (OHSC) in detecting endometrial pathology. Results were compared to available scientific evidence available among similar published studies. Methods: Comparative Retrospective study performed at the Endoscopic Unit,
Diagnostic value of saline infusion sonohysterography for detecting endometrium focal leson
Pan African Medical Journal, 2019
Introduction: different diagnostic tools are available to evaluate endometrial focal lesion such as hysteroscopy, sonohystrography and transvaginal ultrasound. The present study aimed to determine the diagnostic value of saline infusion sonohystrography (SIS) in diagnosis of intrauterine lesions in women with Abnormal Uterine Bleeding (AUB). Methods: this cross-sectional study recruited 100 married women with chief complain of AUB referred to gynecologic clinics at the Amir Al-Momenin hospital, Semnan, Iran from March 2014 to February 2016. All participants were in the reproductive age and post-menopausal period that showed abnormal endometrial thickness or endometrial focal lesions through transvaginal ultrasound. Participants underwent SIS, hysteroscopy plus focal lesion resection and endometrial biopsy in order. The gold standard was the histopathology of endometrial specimen reported by pathologist. Results: mean±SD age of women was 41.2±11.3 years. To diagnose the overall focal lesions, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the SIS were 79.6, 89.1, 89.6, and 78.8% respectively. These figures were 75.0, 87.5, 82.5 and 81.7%, respectively to diagnose polyps. The SIS sensitivity, specificity, PPV and NPV values to diagnose the myomas were 60.0, 97.8, 75.0, and 95.7% respectively. Conclusion: findings show that, SIS probably is a proper method for detecting endometrial focal lesion including polyps and myomas. Future studies may help to define further advantages of this procedure.
Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis
To evaluate the diagnostic accuracy of transvaginal sonography (TVS) in infertile patients and compare its results with hysteroscopy, as the gold standard. Materials and Methods: A total of 679 infertile women who underwent both TVS and diagnostic hysteroscopy were retrospectively investigated. TVS was performed in the mid-follicular phase (days 5-8) of their cycles. Sensitivity, specificity, and positive and negative predictive values were calculated for TVS. Results: Hysteroscopy diagnosed endometrial polyps in 197 out of 679 cases (24.5%). TVS confirmed the hysteroscopy findings in 174 of 197 (88.3%) cases. The sensitivity, specificity, and positive and negative predictive values of TVS compared to hysteroscopy in the detection of endometrial polyps were 88.3%, 91.9%, 81.6% and 90.8%, respectively. Conclusion: TVS is both a cost-effective and non-invasive method for the diagnosis of intrauterine lesions such as polyps. When used in conjunction with a saline infusion, it can be a proper alternative for diagnostic hysteroscopy that saves time and enables the surgeon to perform the operative hystroscopy procedure with greater accuracy.
Citation: Faryal Khan, et al. (2016) Diagnostic Accuracy of Saline-Contrast Sonohysterography Guided Biopsy versus Office Biopsy in Endometrial Pathology: an Interventional Study. J Womens Health Gyn 1: 1-9. Abstract Purpose : The primary objective of this study is to evaluate the effectiveness of Saline Contrast Sonohysterography guided biopsy (SCSH GB) as compared with Endometrial Office Biopsy (EOB) in diagnosing endometrial pathologies by the adequacy of the sample and comparison of the pathologic diagnosis confirmed by hysteroscopy or hysterectomy (histological and anatomical). Methods: Unselected consecutive 250 patients aged 40 years and above with AUB and abnormal endometrium on trans-vaginal ultrasound presenting to ultrasound unit and outpatient department at Women Specialized Hospital, King Fahad Medical City, Riyadh, KSA were screened for eligibility in this interventional study. Fifty percent of enrolled patients were initially booked for SCSH GB then scheduled for EOB. Whereas, the remaining 50% underwent EOB first and then had SCSH GB. This method was used to control the issue of insufficient biopsy. The diagnosis was categorized as 1) physiological 2) benign polyp or sub-mucous fibroid and 3) hyperplasia/cancer. Results: Out of 113 patients 93 underwent both SCSH GB and EOB procedures and were entered into final data analysis. SCSH GB (94.6%) achieved significantly higher sample adequacy compared to 86% of EOB (p<0.001). SCSHGB significantly diagnosed all 29 (100%) polyps and sub-mucous fibroids confirmed by hysteroscopy/hysterectomy versus only 8 (27.5%) cases by EOB (p<0.001). Conclusions: The SCSH GB technique can be a reasonable alternative to EOB in pre-and post-menopausal women aged 40 and older with AUB.
American Journal of Obstetrics and Gynecology, 1996
OBJECTIVE: Intrauterine infusion of saline solution during transvaginal ultrasonography enhances visualization of the endometrium. We compared the accuracy and pain rating of saline infusion sonography with those of flexible office hysteroscopy. STUDY DESIGN: The uterine cavities of 130 patients with abnormal bleeding were evaluated by two physicians in an office setting. Findings of endometrial polyps, submucous myomas, synechiae, endometrial hyperplasia, or cancer were recorded independently and subsequently compared. Patients rated their pain after each procedure. RESULTS: Both procedures were performed in 113 of 130 patients. With saline infusion sonography pathologic findings were identified in 61 patients (54%). For all findings combined, sensitivity was 0.96 and specificity was 0.88, compared with hysteroscopy. The results of saline infusion sonography and hysteroscopy did not differ significantly (/3 = 0.18). The former was less painful for patients than hysteroscopy (/3 < 0.0001). CONCLUSION: Saline infusion sonography is an accurate and well-tolerated method to evaluate abnormal uterine bleeding, compared with hysteroscopy. (AM J OBSTET GYNECOL 1996;174:1327-34.)
Ultrasound in Obstetrics & Gynecology, 1998
The availability of advanced hysteroscopic surgical techniques has changed the management of abnormal uterine bleeding. The aim of this study was to evaluate the use of transvaginal sonography (TVS), sonohysterography (SH) and diagnostic hysteroscopy (DH) for the preoperative assessment of the uterine cavity. The plan was to investigate 100 patients with abnormal uterine bleeding despite conventional medical treatment. The endpoints were uterine abnormalities detected by operative hysteroscopy and histology, and subjective estimates of discomfort during TVS and SH. A total of 104 patients (aged 26–79 years) were recruited and 98 (94%) underwent all three diagnostic procedures. Uterine abnormalities were present in 52 patients (53%). There were 25 cases with at least one endometrial polyp, 17 with submucous fibroids, seven with endometrial hyperplasia and three with an adenocarcinoma. The overall sensitivity of TVS improved after SH from 67 to 87% and the specificity from 89 to 91%. The positive predictive value increased from 88 to 92% and the negative predictive value from 71 to 86%. The use of SH also improved the quality of information about the location and size of polyps and submucous fibroids. Increased endometrial thickness associated with adenocarcinoma was detected in all cases (three of three) by TVS and in four of seven cases of hyperplasia (five of seven cases after SH). Most patients reported minor discomfort during TVS or SH and no side-effects were apparent. The sensitivity of DH was 90% (92% for polyps, 88% for fibroids); two cases with a polyp, two with a submucous fibroid and one with endometrial hyperplasia were not detected. The use of saline infusion to enhance visualization of the endometrium increases the diagnostic accuracy of transvaginal sonography to approach that of diagnostic hysteroscopy and also provides some additional information. This development has implications for the management of uterine bleeding disorders. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology