The short-term clinical outcomes after saline infusion sonohysterography in women with postmenopausal bleeding.
OBJECTIVE
To describe the short-term clinical outcomes of women with postmenopausal bleeding (PMB) who underwent saline-infused sonohysterography (SIS) and the impact of SIS results on clinical management.


METHODS
A retrospective review of the Radiology Information Systems database identified 786 women who underwent SIS between February 1998 and October 2002. Of this group, 144 women (mean age, 60; range, 42-83) presented with PMB. The following clinical data were extracted from the electronic medical record: date of birth, hormone replacement therapy (HRT) status, SIS results, and clinical management before and after the SIS procedure. We categorized post-SIS clinical management into three categories: additional diagnostic or therapeutic procedure performed; HRT change or addition; or no change in clinical management. Between-group comparisons were performed using a chi2 test.


RESULTS
Of the 144 women with postmenopausal bleeding who underwent SIS, 119 (82.6%) successfully completed the SIS. Eighty women (67.2%) had a positive SIS exam. Abnormalities detected including polyps (n = 42); submucosal fibroids (n = 6); endometrial thickening (n = 8); a combination of 2 or more of the above (n = 7), or other abnormalities (debris, adenomyosis, or indeterminate findings, n = 17). Of the women with a positive SIS exam, 58% received subsequent diagnostic/therapeutic procedures compared to 5% of women who had a negative SIS (P < 0.001). Conversely, 59% of women with a negative SIS had no change in clinical management compared to 17.5% who had a positive SIS (P < 0.001).


CONCLUSIONS
The trend in short-term clinical management is to pursue more aggressive subsequent diagnostic or treatment procedures if findings are positive on SIS. A negative SIS exam was associated with more conservative management.
Meng
Kenneth
K
Department of Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0030, USA.
Branam
Jill D
JD
Nghiem
Hanh V
HV
Carlos
Ruth C
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004717:Endometrium / Q000000981:diagnostic imaging / Q000503:physiopathology; D019160:Endosonography / Q000379:methods*; D015914:Estrogen Replacement Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011127:Polyps / Q000175:diagnosis; D017698:Postmenopause; D012189:Retrospective Studies; D012965:Sodium Chloride; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology
D012965:Sodium Chloride