A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women

Abstract

Although there was considerable variability present between the studies, all three diagnostic tests were moderately accurate in detecting intrauterine pathology. However, sonohysterography and hysteroscopy performed better than transvaginal ultrasound in detecting submucous fibroids.

A new method of transvaginal ultrasound-guided polypectomy: a feasibility study

“…The technique of hysteroscopic polypectomy varies between operators. Many surgeons use the hysteroscope to diagnose an endometrial polyp 7 , which is then removed blindly using polyp forceps. The completeness of the polypectomy is then checked by re-insertion of the hysteroscope.…”

“…This is an accurate technique for the diagnosis of intrauterine pathology 6,7 and it allows the operator to obtain directed biopsies of the endometrium as well as to resect focal lesions such as endometrial polyps. However, hysteroscopy is an expensive procedure and is associated with complications including uterine perforation and ascending genitourinary tract infection 8 -10 .…”

Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta‐analysis

“…In their review, the inclusion criteria led to retrieval of studies with at least 60% of the women being of reproductive age and at least 50% of the women having menstrual disorders. Such eligibility criteria, as presented by the authors, constituted a source of considerable variability in the results 21 . Of the five studies included in our systematic review, all provided information that allowed calculation of the accuracy of 2D-SCSH for diagnosing endometrial polyps, but only four studies provided data related to submucosal uterine leiomyomas.…”

Acute Uterine Bleeding Unrelated to Pregnancy: A Southern California Permanente Medical Group Practice Guideline

“…Nevertheless, transvaginal ultrasound is less sensitive than other techniques such as hysteroscopy and contrast sonography (typically saline infusion sonography) at detecting intrauterine lesions, especially polyps 45 (Class 3). A Cochrane systematic review also suggests that transvaginal ultrasound is almost as accurate as saline infusion sonography and hysteroscopy, but the review did not include such an evaluation for women with acute abnormal uterine bleeding 46 (Class 1a). The exception was a slightly lower sensitivity for the detection of submucous leiomyomas.…”