Artur Ludwin1, Inga Ludwin2, Marek Kudla3, Kazimierz Pitynski4, Tomasz Banas4, Robert Jach4, Anna Knafel4. 1. Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland; Centermed Hospital and Clinic, Krakow, Poland; Ludwin and Ludwin Gynecology, Medical Center, Krakow, Poland. Electronic address: ludwin@cm-uj.krakow.pl. 2. Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland; Centermed Hospital and Clinic, Krakow, Poland; Ludwin and Ludwin Gynecology, Medical Center, Krakow, Poland. 3. Department of Obstetrics and Gynecology, Medical University of Silesia, Katowice, Poland. 4. Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland.
Abstract
OBJECTIVE: To compare the diagnostic accuracy of three-dimensional sonohysterography (3D-SIS) and office hysteroscopy in uterine cavity assessment after hysteroscopic metroplasty (HM) and determine the interrater/intrarater agreement for 3D-SIS. DESIGN: Prospective observational study. SETTING:University hospital, private hospital, and clinic. PATIENT(S): One hundred forty-one women undergoing HM for septate uterus with a history of miscarriage and/or infertility. INTERVENTION(S): 3D-SIS and office hysteroscopy at 6-8 weeks after HM. MAIN OUTCOME MEASURE(S): Shape of the uterine cavity, length of the fundal notch (≥1 or <1 cm), and the presence of intrauterine adhesions were assessed, and the interrater/intrarater agreement of 3D-SIS was evaluated in 30 randomly selected patients. RESULT(S): Uterine abnormalities were detected with the use of hysteroscopy in 18 (12.8%) of 141 women. 3D-SIS was highly accurate (97.2%), sensitive (97%), and specific (100%), with a positive predictive value of 100% and a negative predictive value of 85%. The diagnostic values of hysteroscopy and 3D-SIS were not significantly different (McNemar test). 3D-SIS showed substantial interrater/intrarater agreement regarding overall uterine cavity evaluation (κ = 0.79 and 0.78, respectively). CONCLUSION(S): 3D-SIS demonstrated substantial interrater/intrarater agreement for the postoperative evaluation of the uterine cavity, being as diagnostically accurate as hysteroscopy. The use of second-look hysteroscopy may be limited to cases that require reoperation.
RCT Entities:
OBJECTIVE: To compare the diagnostic accuracy of three-dimensional sonohysterography (3D-SIS) and office hysteroscopy in uterine cavity assessment after hysteroscopic metroplasty (HM) and determine the interrater/intrarater agreement for 3D-SIS. DESIGN: Prospective observational study. SETTING: University hospital, private hospital, and clinic. PATIENT(S): One hundred forty-one women undergoing HM for septate uterus with a history of miscarriage and/or infertility. INTERVENTION(S): 3D-SIS and office hysteroscopy at 6-8 weeks after HM. MAIN OUTCOME MEASURE(S): Shape of the uterine cavity, length of the fundal notch (≥1 or <1 cm), and the presence of intrauterine adhesions were assessed, and the interrater/intrarater agreement of 3D-SIS was evaluated in 30 randomly selected patients. RESULT(S): Uterine abnormalities were detected with the use of hysteroscopy in 18 (12.8%) of 141 women. 3D-SIS was highly accurate (97.2%), sensitive (97%), and specific (100%), with a positive predictive value of 100% and a negative predictive value of 85%. The diagnostic values of hysteroscopy and 3D-SIS were not significantly different (McNemar test). 3D-SIS showed substantial interrater/intrarater agreement regarding overall uterine cavity evaluation (κ = 0.79 and 0.78, respectively). CONCLUSION(S): 3D-SIS demonstrated substantial interrater/intrarater agreement for the postoperative evaluation of the uterine cavity, being as diagnostically accurate as hysteroscopy. The use of second-look hysteroscopy may be limited to cases that require reoperation.
Authors: J F W Rikken; K W J Verhorstert; M H Emanuel; M Y Bongers; T Spinder; W K H Kuchenbecker; F W Jansen; J W van der Steeg; C A H Janssen; K Kapiteijn; W A Schols; B Torrenga; H L Torrance; H R Verhoeve; J A F Huirne; A Hoek; T E Nieboer; I A J van Rooij; T J Clark; L Robinson; M D Stephenson; B W J Mol; F van der Veen; M van Wely; M Goddijn Journal: Hum Reprod Date: 2020-07-01 Impact factor: 6.918
Authors: Ahmed S A Sabry; Shimaa A Fadl; Wojciech Szmigielski; Amal Alobaidely; Sanaa S H Ahmed; Hanan Sherif; Reda R H Yousef; Ahmed Mahfouz Journal: Pol J Radiol Date: 2018-11-30
Authors: J F W Rikken; C R Kowalik; M H Emanuel; M Y Bongers; T Spinder; J H de Kruif; K W M Bloemenkamp; F W Jansen; S Veersema; A G M G J Mulders; A L Thurkow; K Hald; A Mohazzab; Y Khalaf; T J Clark; M Farrugia; H A van Vliet; M S Stephenson; F van der Veen; M van Wely; B W J Mol; M Goddijn Journal: BMC Womens Health Date: 2018-10-05 Impact factor: 2.809