Comparison of transvaginal sonography, saline infusion sonography, and office hysteroscopy in reproductive-aged women with or without abnormal uterine bleeding

Abstract

To compare the diagnostic accuracy and acceptability of transvaginal sonography (TVS), saline infusion sonography (SIS), and office hysteroscopy (OHS) for detecting intracavitary abnormalities in women with or without abnormal uterine bleeding (AUB). Prospective double-blind study. Zekai Tahir Burak Women's Health Education and Research Hospital, Gynecology Clinic (Ankara, Turkey). A total of 26 women with AUB and 24 women without AUB were enrolled in this study. Transvaginal sonography, SIS, and OHS were performed on women scheduled for hysterectomy. Sensitivity, specificity, and positive and negative predictive values of TVS, SIS, and OHS to detect intracavitary abnormalities (with histopathologic findings used as the gold standard), duration of procedure, and pain scores. The sensitivity and specificity of TVS, SIS, and OHS in detecting intracavitary abnormalities were 56.3% and 72%, 81.3% and 100%, and 87.5% and 100%, respectively. The prevalence of endometrial polyps was not different in women with and without AUB. Saline infusion sonography was less painful than OHS (pain scores of 4.3 and 7.2, respectively). The diagnostic accuracy of SIS was equal to that of OHS in diagnosing intracavitary abnormalities. Moreover, SIS was less painful than OHS for patients.