A comparison of outpatient hysteroscopy with saline infusion hysterosonography.
OBJECTIVE
To establish the accuracy of saline infusion hysterosonography in diagnosing uterine pathology when compared with outpatient hysteroscopy.


METHODS
Prospective, parallel, blinded comparative study.


METHODS
Outpatient hysteroscopy clinic in a large university teaching hospital.


METHODS
All women referred for outpatient hysteroscopy in a 15-month period.


METHODS
Women underwent saline infusion hysterosonography followed by flexible hysteroscopy. The ultrasonographer was blinded to the hysteroscopy result and the gynaecologist was blinded to the saline infusion hysterosonography result.


METHODS
The relative success rates and pain scores for each procedure. The validity of saline infusion hysterosonography as a diagnostic test.


RESULTS
One hundred and seventeen women entered the study; 70 women were premenopausal and 47 postmenopausal. In 27 women, one or both procedures could not be performed. Saline infusion hysterosonography failed in 20 women, on one occasion hysteroscopy failed and both investigations failed in six women. Ninety cases remained for direct comparison, with 78 cases of agreement on the uterine findings in both investigations. Twelve cases disagreed; in one case, an adhesion was seen, two cases with polyps and five with fibroids seen on ultrasound but not seen on hysteroscopy. There were four cases where polyps were identified on hysteroscopy but not on saline infusion hysterosonography. The median pain scores were 1.6 for saline infusion hysterosonography and 3.2 for hysteroscopy.


CONCLUSIONS
Both saline infusion hysterosonography and hysteroscopy are well tolerated by women. Saline infusion hysterosonography has a high failure rate but has a lower pain score than hysteroscopy.
Department of Obstetrics and Gynaecology, St James's University Hospital, Leeds, UK.
Lynne
L
Rogerson
Jane
J
Bates
Mike
M
Weston
Sean
S
Duffy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007262:Infusions, Intravenous; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D014463:Ultrasonography; D014591:Uterine Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014599:Uterus / Q000000981:diagnostic imaging
D012965:Sodium Chloride