A simple one-stop menstrual problem clinic with use of hysterosonography for the diagnosis of abnormal uterine bleeding

Dueholm, Margit; Laursen, Hanne; Knudsen, UllaBreth

doi:10.1080/j.1600-0412.1999.780214.x

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…9 SIS may be useful for gynecologists who do not perform diagnostic hysteroscopy, especially since SIS may be performed in an outpatient setting. 18 Moreover, SIS may be used as an initial test to triage patients with ab- normal uterine bleeding for diagnostic or operative hysteroscopy. Our data correspond to those in the literature, in which SIS had an 88-100% sensitivity for diagnosing intracavitary abnormalities and a 76-98% specificity ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding

Vries¹,

Dijkhuizen²,

Mol³

et al. 2000

J. Clin. Ultrasound

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Purpose Saline infusion sonography (SIS) is a relatively new technique in the evaluation of abnormal uterine bleeding. We compared the diagnostic accuracy of SIS with that of transvaginal sonography (TVS) in the detection of intracavitary abnormalities in premenopausal women with abnormal uterine bleeding. Methods In this prospective study, consecutive premenopausal women who underwent a hysteroscopy for abnormal uterine bleeding also underwent TVS and SIS. The findings at TVS and SIS were compared with the hysteroscopic and histologic findings. Sensitivity, specificity, and likelihood ratios were calculated. Receiver operating characteristic curves were constructed to assess the performance of endometrial thickness measured using TVS. Results Sixty‐two patients were included in the study. TVS demonstrated 60% sensitivity in directly visualizing intracavitary abnormalities and 93% specificity. The likelihood ratio of the presence of an intracavitary abnormality was 8, and the likelihood ratio of the absence of an intracavitary abnormality was 0.43. Defining an abnormality at TVS as direct visualization of an intracavitary abnormality or an endometrial thickness greater than 5 mm, TVS had an 85% sensitivity and a 21% specificity, with corresponding likelihood ratios of 1.1 and 0.71, respectively. For SIS, the sensitivity, specificity, and likelihood ratios of the presence and absence of intracavitary abnormalities were 88%, 95%, 10, and 0.13, respectively. Conclusions SIS is more accurate in the diagnosis of intracavitary abnormalities in premenopausal women than is TVS. An approach using endometrial thickness measurement by TVS and reserving SIS for patients who have an endometrial thickness greater than 5 mm or an intracavitary abnormality visualized by TVS would be the most effective method to reduce the number of hysteroscopies. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:217–223, 2000.

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Section: Discussionmentioning

confidence: 99%

Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding

Vries¹,

Dijkhuizen²,

Mol³

et al. 2000

J. Clin. Ultrasound

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“…Rana and Siddiqui (13) confirmed the high diagnostic accuracy of SHG in infertility cases and added an advantage of using it as a reliable tubal patency test. Dueholm et al (14) examined patients with abnormal uterine bleeding using a one-stop outpatient policy consisting of pelvic sonography, hysterosonography and, when indicated, endometrial sampling. They obtained a sufficient diagnosis in 93% of cases.…”

Section: Discussionmentioning

confidence: 99%

Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps

Kamel

Darwish

Mohamed

2000

Acta Obstet Gynecol Scand

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“…Four senior registrars and one consultant with routine experience in vaginal ultrasound were involved. Data from 95 patients from one center have been presented in a previous paper (12) describing the organization of a simple one‐stop menstrual problem clinic using HSE. The diagnostic accuracy of HSE in our hands has also been reported (in press).…”

Section: Methodsmentioning

confidence: 99%

Can the endometrial thickness as measured by trans‐vaginal sonography be used to exclude polyps or hyperplasia in pre‐menopausal patients with abnormal uterine bleeding?

Dueholm

Jensen

Laursen

et al. 2001

Acta Obstet Gynecol Scand

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Acta Obstet Gynecol Scand 2001; 80: 645-651. C Acta Obstet Gynecol Scand 2001 Background. To combine findings of normal mid-line echoes from TVS (trans-vaginal sonography) with cut-off levels for endometrial thickness, in order to examine the associated risk of abnormalities in the uterine cavity. Design and Setting. Two center prospective study at a university clinic and a central hospital in Denmark. Participants. Three hundred and fifty-five pre-menopausal patients with abnormal uterine bleeding, and indications for endometrial sampling or surgery.Interventions. The thickness of the endometrium was measured, and the mid-line echoes were evaluated using TVS. The findings from the endometrial sampling, combined with the evaluation of the uterine cavity using operative hysteroscopy (115), hysterectomy (74) or HSE (hysterosonographic examination) (166), were used as the true values. Results. The mean (∫s.d.) endometrial thickness was significantly different in patients with hyperplasia 11.5 mm (∫5.0), polyps 11.8 mm (∫5.1), sub-mucous myomas 7.1 mm (∫3.4) and in patients without these abnormalities 8.37 (∫3.9) (pϽ0.001). Hyperplasia and/or polyps were present in 20% of all patients, and in 8% of 143 patients with an endometrial thickness of AE7 mm. This proportion did not decrease with lower cut-off levels for endometrial thickness. Receiver operating characteristic (ROC) curves were not optimal for excluding hyperplasia or polyps by endometrial thickness. In 173 cases with a distinct, regular midline echo without echo-dense foci in TVS the proportion of patients with abnormalities was 16% (11-23). This proportion did not decrease with cut-off levels for endometrial thickness. Conclusions. Using TVS, low levels of endometrial thickness reduced the possibility of abnormalities such as polyps and hyperplasia, but did not exclude them. Low cut-off levels for endometrial thickness did not increase the diagnostic performance in cases with normal sonograms.

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A simple one-stop menstrual problem clinic with use of hysterosonography for the diagnosis of abnormal uterine bleeding

Cited by 14 publications

References 21 publications

Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding

Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding

Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps

Can the endometrial thickness as measured by trans‐vaginal sonography be used to exclude polyps or hyperplasia in pre‐menopausal patients with abnormal uterine bleeding?

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