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Hysterosonography: evaluation of the uterine cavity in women with abnormal uterine bleeding

OBJECTIVE: To compare the diagnostic accuracy of sonohysterography with that of hysteroscopy and ultrasonography for the diagnosis of uterine alterations with abnormal uterine bleeding. METHODS: Fifty three patients scheduled for hysteroscopy at the Hysteroscopy Sector of the Women's Hospital (CAISM) at the "Universidade Estadual de Campinas" (Brazil) were included in the study. Sensitivity and specificity of the three propaedeutic methods were compared using histology as the gold standard. RESULTS: Sensitivity of sonohysterography and of hysteroscopy was 94% and that of ultrasonography 83%. The specificity of sonohysterography was 77%, of hysteroscopy 91% and of ultrasonography 69%. There were no significant differences between sensitivities of the three methods. However, a significant difference was found between the specificity of ultrasonography and hysteroscopy. Sonohysterography demonstrated a much greater capability than ultrasonography to identify endometrial polyps. CONCLUSION: Sonohysterography may be used to complement ultrasonography and to substitute hysteroscopy, for the diagnosis of alterations that result in abnormal uterine bleeding.

Sonohysterography; Hysteroscopy; Ultrassonography; Abnormal uterine bleeding


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