Uterine cavity assessment in infertile women: comparison of transvaginal sonography and hysteroscopy.
OBJECTIVE
To evaluate the diagnostic accuracy of transvaginal sonography (TVS) in detecting uterine cavity abnormalities in infertile patients, with reference to hysteroscopy as the gold standard method.


METHODS
At the Institute of Obstetrics and Gynaecology, University of Bari, 134 infertile women were investigated with both TVS and hysteroscopy. In all cases endometrial biopsy was performed. Sensitivity, specificity, and positive and negative predictive values were calculated for TVS, considering hysteroscopic diagnosis as the gold standard. Statistical analysis was performed by using McNemar test.


RESULTS
There was one failed insertion of hysteroscope. Hysteroscopy diagnosed pathological findings in 58 out of 133 cases (44%). TVS was in agreement with 50 of the 58 (86%) of the pathological findings diagnosed at hysteroscopy. As a test for the detection of uterine cavity abnormalities, TVS in comparison with hysteroscopy had 84.5% sensitivity and 98.7% specificity, 98.0% positive predictive value and 89.2% negative predictive value.


CONCLUSIONS
TVS is able to diagnose polyps, septum and submucous fibroids with quite significant accuracy, while hysteroscopy is indicated for their confirmation and removal. Thus, hysteroscopy provides both diagnostic and therapeutic capabilities, but TVS permits to proceed directly to operative hysteroscopy avoiding the need for a separate diagnostic procedure.
Loverro
G
G
Institute of Obstetrics and Gynaecology II, University of Bari, Piazza Giulio Cesare, 70124 Bari, Italy .
Nappi
L
L
Vicino
M
M
Carriero
C
C
Vimercati
A
A
Selvaggi
L
L
D001706:Biopsy; D004715:Endometriosis / Q000000981:diagnostic imaging; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000473:pathology; D010048:Ovarian Cysts / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000473:pathology; D014621:Vagina