Abstract:

INTRODUCTION: The aim of this study is to compare the accuracy of transvaginal sonography, saline infusion sonography and diagnostic hysteroscopy in the detection of intracavitary pathologies in premenopausal women with abnormal uterine bleeding. METHODS: In the period from July 2007 to July 2008, women who were referred for abnormal uterine bleeding to Ministry of Health Goztepe Research and Training Hospital Department of Obstetrics and Gynecology, gynecology outpatient clinic, were evaluated retrospectively. Records of patients who have been operated because of abnormal uterine bleeding were taken out from the archive. All patients underwent pelvic examination, transvaginal ultrasonography, diagnostic hysteroscopy and endometrial sampling through suction curettage. The findings of transvaginal ultrasonography, saline infusion sonography and diagnostic hysteroscopy were compared with the findings of endometrial sampling and all findings were compared with the findings of combined hysteroscopy and hystology. Sensitivity, specificity, positive and negative predictive values were calculated. RESULTS: A total of 35 premenopausal women with abnormal uterine bleeding were evaluated. Detailed pathology results indicated that 51% of the premenopausal patients in the research group had endometrial pathology. When TVUSG is compared with endometrial biopsy, its sensitivity, specifity, positive and negative predictive values for detecting endometrial pathologies were found to be 61 %, 71 %, 69 % and 63 %, respectively. When SIS is compared with endometrial biopsy, its sensitivity, specifity, positive and negative predictive values for detecting endometrial pathologies were found to be 78 %, 82 %, 82 % and 78 %, respectively. When diagnostic hysteroscopy is compared with endometrial biopsy, its sensitivity, specifity, positive and negative predictive values for detecting endometrial pathologies were found to be 89 %, 76 %, 80 % and 87 %, respectively. Diagnostic accuracies of hysteroscopy and SIS were found to be greater than that of TVUSG for the detection of abnormalities like polyps and submucous myomas in the intrauterine cavity. DISCUSSION AND CONCLUSION: In premenopausal patients, SIS and hysteroscopy have close accuracies in the diagnosis of endometrial polyps and submucous myomas. For the evaluation of endometrial pathology, combination of hysteroscopy and endometrial sampling gives the best diagnostic accuracy.

Keywords: