Saline infusion sonography (SIS) as a diagnostic tool for various endometrial pathologies and its comparison with hysteroscopy and histopathology

Abstract

Aims and Objective: To assess the role of saline infusion sonography (SIS) in diagnosing endometrial pathologies in young, peri and postmenopausal women and its comparison with hysteroscopy and histopathology. Materials and Methods: The study was conducted in Department of Obstetrics & Gynaecology in N.S.C.B. Medical College, Jabalpur from 1st July 2009 to 31st August 2010. A total of 78 patients in reproductive peri and postmenopausal age group meeting the inclusion criteria were subjected to underwent saline infusion sonography and then hysteroscopy examination and histopathological examination. Result of saline infusion sonography testing was compared with hysteroscopy and histopathological examination of specimen. Results: Total of 78 patients scheduled for saline infusion sonography (SIS). The most common presenting symptom was menorrhagia in 29 (38%) followed by lower abdominal pain in 18 (23). Out of the total 78 patients who underwent SIS, 44(56.5%) patients had endometrial hyperplasia, 18(23%) - endometrial polyp, 6(8%) - submucous fibroid, 4(5%) - atrophic endometrium, 2(2.5%) - irregular thick bands, 2(2.5%) -retained products of conception, 2(2.5%)-normal endometrium. Out of 78 patients underwent SIS followed by hysteroscopy and histopathological examination 40(51.4%) patient had endometrial hyperplasia, 18(23%) - endometrial polyp, 6(8%) - submucous fibroid, 1(1.2%) - atrophic endometrium, 2(2.5%) - carcinoma endometrium, 1(1.2%) - retained products, 4(5%) - hyperplasia and polyp both, 1(1.2%) - intrauterine adhesions (Asherman’s syndrome) and normal endometrium in 5(6.5%)patients. When all findings are combined the specificity, sensitivity, Positive Predictive Value and NPV of SIS are 89.3 %, 91.2 %, 87.2% and 94.2 % respectively. Conclusions: Saline infusions sonography (SIS) is a simple, non invasive, well tolerated procedure to diagnose various endometrial pathologies. The findings of SIS, hysteroscopy and histopathology did not differ significant