Abstract
IntroductionDifferent 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).MethodsThis 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.ResultsMean±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.ConclusionFindings 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.
Highlights
Abnormal uterine bleeding (AUB) is one of the most common disorders in women at the childbearing age
Polyp was the most common focal lesion found by the Saline Infusion Sonohystrography (SIS) (40.0%) and the hysteroscopy (47.0%)
SIS probably is a proper method for detecting endometrial focal lesion including polyps and myomas
Summary
Abnormal uterine bleeding (AUB) is one of the most common disorders in women at the childbearing age. It has been estimated that more than 30% of referrals to the women health centers are related to the AUB; it is worth to notice that some patients may not be referred [1]. This fact might explain why the prevalence of the AUB in different studies had a range from 10 to 52% [4,5,6]. Transvaginal Sonography (TVS) is the first measure to diagnose abnormal endometrium proliferation in the AUB condition in the preand post-menopausal ages [14,15], while, Saline Infusion Sonohystrography (SIS) seems to be superior to TVS, for uterine pathologies [16]. This study aimed to investigate the sensitivity, specificity, positive and negative predictive values of the SIS
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