[Value of saline infusion sonohysterography and hysteroscopy in postmenopausal patient with persistent abnormal ultrasonographic images after endometrial curettage with normal histological results].

AIM OF THE STUDY: Comparison of sonohysterography vs. outpatients diagnostic hysteroscopy in evaluation postmenopausal patient with persistent abnormal ultrasounds images after endometrial curettage revealed normal histological result.
MATERIALS AND METHODS: Material consisted of 47 postmenopausal women age 44-91 years, diagnosed because of abnormal uterine bleeding and/or suspicious endometrial ultrasonographic pictures performed a month after curettage. Patients were evaluated by diagnostic sonohysterography (without analgaesia) and outpatients diagnostic hysteroscopy (local analgaesia). Outcomes of sonohysterography and hysteroscopy were compared with results of histological examinations of specimen (hysteroscopical biopsy, hysteroscopical resection or hysterectomy). Sensitivity and specificity of two diagnostic methods were compared.
RESULTS: Intrauterine cause of abnormal ultrasonographic picture was disclosed by sonohysterography in 35 (74.46%) cases. Suspicious of focal endometrial carcinoma in SIS was reported in 1 (2.12%) case. Sensitivity of SIS in relation to all pathology was 0.97, specificity 0.90. Sensitivity and specificity amounted in relation to: polyps 1.00 and 0.83, hyperplasia 0.84 and 0.95. There was no significant statistical differences in sensitivity and specificity between SIS and diagnostic hysteroscopy.
CONCLUSION: Diagnostic hysteroscopy and sonohysterography have the same diagnostic potential in evaluation of endometrium. Both methods are useful in patient with unsuspected histological results of the specimens. Ultrasonographic pictures imitating endometrial carcinoma or endometrial hyperplasia in most cases are connected with endometrial polyp. Advantage of applying liquid medium in SIS seems surpass the risk of passage of cells of carcinoma to peritoneal cavity.