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KMID : 1216720110030020117
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Korean Journal of Gynecologic Endocrinology
2011 Volume.3 No. 2 p.117 ~ p.123
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Flexible Hysteroscopy versus Saline Infusion Sonography for Uterine Cavity Assessment
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Lee Jung-Ryeol
Jang Eun-Jeong
Jee Byung-Chul
Kim Yong-Beom
Suh Chang-Suk
Kim Seok-Hyun
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Abstract
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Objectives: To compare predictive values of flexible hysteroscopy (FH) and saline infusion sonography (SIS) for
the detection of abnormalities in outpatients undergoing uterine cavity assessment.
Methods: A total of 83 women underwent uterine cavity assessment using office FH and/or SIS were included.
After operative procedure (dilatation and curettage and biopsy, or operative hysteroscopy), histopathologic results
were used as a gold standard to calculate predictive values of FH and SIS.
Results: Of 83 patients, 71 and 67 underwent FH and SIS, respectively. Both procedures were done in 55 patients.
Transvaginal ultrasonography findings before procedure were endometrial polyp (42.2%), thickened endometrium
(31.3%), submucosal myoma (14.5%), and endometrial fluid (1.2%). Histological diagnoses were endometrial polyp
(43.4%), no abnormal finding (39.8%), leiomyoma (14.5%), and adenocarcinoma (2.4%). As a screening test for
uterine cavity assessments, FH had 100% sensitivity, 88.9% specificity, 93.2% positive predictive value (PPV) and
100% negative predictive value (NPV), and SIS had 90.5% sensitivity, 87.5% specificity, 92.7% PPV and 84%
NPV. All these four values were higher in FH than SIS,but these differences were not statistically significant.
Diagnostic accuracy of FH and SIS were 89.7% and 84.8 %, respectively.
Conclusion: Our results suggest that office FH and SIS both have good predictive values for uterine cavity
assessment. Office FH, easily performed and provides direct intrauterine visibility, could be an optimal option for
outpatient evaluation of uterine cavity.
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KEYWORD
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Flexible hysteroscopy, Saline infusion sonography, Uterine cavity
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