Role of saline infusion sonohysterography in the evaluation of abnormal uterine bleeding

Abstract

Objectives: The aim of this study is to determine the accuracy of saline infusion sonohysterography in the evaluation of abnormal uterine bleeding and correlate with the histopathological findings. Methods: This study was conducted in patients with abnormal uterine bleeding refractory to medical management in a prospective manner. All patients underwent transabdominal and transvaginal sonography before sonohysterography followed by appropriate interventions. SPSS 20 and STATA 11 were used for data analysis. Results: In this study 55.2% patients underwent a dilatation and curettage while as 44.8% underwent total abdominal hysterectomy. In 65.2% patients who underwent (Total abdominal hysterectomy) TAH had few or multiple intramural fibroids. Three patients had submucous fibroids none of which were detected on TAS (Trans abdominal sonography) or TVS (Trans vaginal sonography). Saline infusion sonohysterography (SIS) detected 2 of these correctly. SIS had a sensitivity of 66.67%, specificity of 95.65% and accuracy of 92.30% for adenomyosis. In 27.6% patients were found to have polyps on SIS with a sensitivity of 100%, specificity of 95.4%, PPV of 87.5%, NPV of 100% and accuracy of 96.67%. Conclusion: Saline contrast sonohysterography is a simple, safe, reliable, well-tolerated, sensitive and specific procedure for detecting focally growing lesions in the uterine cavity in women with abnormal uterine bleeding

Keywords

• abnormal uterine bleeding
• transabdominal sonography
• sonohysterography