Sonohysterography in the evaluation of endometrial abnormalities

Objective: To compare the efficacy of sonohysterography and hysteroscopy in the diagnosis of endometrial abnormalities. Methods: Sonohysterography was performed on 216 patients for whom transvaginal sonography had suggested an unspecific abnormal endometrial echo. The patients were divided into three groups: 106 women suffering from infertility (Group 1); 53 premenopausal (Group 2) and 57 postmenopausal women (Group 3) affected by abnormal uterine bleeding. Patients of Group 1 and 2 were examined in the early follicular phase, postmenopausal patients were randomly examined. To confirm the ultrasound diagnosis, all the patients underwent hysteroscopy. Results: In Group 1, sonohysterography showed normal cavity in 52 patients, endometrial polyps in 39, submucous myomas in 6, septate uterus in 2 and adhesions in 6 cases. In Group 2 we observed normal cavity in 6, endometrial polyps in 38, submucous myomas in 7 and suspect of carcinoma in 2 cases. In-Group 3 normal cavity, endometrial polyps, submucous myomas and suspect of carcinoma were respectively observed in 17, 36, 1 and 3 patients. Hysteroscopy confirmed the diagnosis in 99.5% of the patients. Conclusion: Our data show that SHG improves transvaginal ultrasound accuracy, is simple to perform, safe and well tolerated by the patients.