The reproductibility of the results of transvaginal sonography of the uterus in patients with abnormal uterine bleeding

Emanuel, M.H.; Ankum, Willem M.; Verdel, Marion J.; Hart, A. A. M.

doi:10.1046/j.1469-0705.1996.08050346.x

Cited by 19 publications

(10 citation statements)

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“…10 Transvaginal sonography has been shown to have high reproducibility and low interobserver variability for the detection of uterine abnormalities. 11 Sonograms were performed by experienced sonographers and physicians, and when possible, we performed the saline infusion sonography shortly after menses had stopped to avoid false-positive saline infusion sonography findings that can occur because of blood clots or tufts of thickened late proliferative or secretory endometrium. 5 Therefore, transvaginal ultrasonography and saline infusion sonography provide an accurate means of detecting and following up even small benign uterine lesions.…”

Section: Discussionmentioning

confidence: 99%

Natural History of Uterine Polyps and Leiomyomata

DeWaay

Syrop

Nygaard

et al. 2002

Obstetrics & Gynecology

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OBJECTIVE:To estimate the incidence and regression rates of uterine leiomyomata and polyps in a cohort of asymptomatic, premenopausal women. METHODS:Saline infusion sonography was performed twice, 2.5 years apart, in a cohort of 64 initially asymptomatic women. Subjects completed a questionnaire that assessed the development of abnormal uterine bleeding. RESULTS:The mean age of women (at second ultrasound) was 44 years. In four of seven women with polyps at the original ultrasound, their polyps regressed. Polyps that regressed tended to be smaller than polyps that persisted. Ten women had endometrial polyps at the second ultrasound for a point prevalence of 16% and a cumulative incidence rate of 12% per 2.5 years. A higher percentage of women with uterine polyps had complaints of abnormal uterine bleeding than women with no uterine abnormalities (70% versus 33%, P ‫؍‬ .04). Six leiomyomata in four women were no longer detected in the second ultrasound. Leiomyomata that regressed were in older premenopausal women and were smaller than leiomyomata that persisted. The point prevalence and incidence rates of leiomyomata were 27% and 13% per 2.5 years, respectively. Leiomyomata grew an average of 1.2 cm per 2.5 years, but great variation in growth rates were noted. CONCLUSION:Small uterine polyps frequently regressed spontaneously, whereas larger polyps were more likely to persist and were associated with the development of abnormal bleeding. Smaller leiomyomata in older premenopausal women also regressed whereas larger leiomyomata tended to grow while often remaining asymptomatic. (Obstet Gynecol 2002;100:3-7. Benign uterine lesions, such as endometrial polyps and leiomyomata, are common in women, especially those over age 35 years. 1-4 Submucosal leiomyomata or polyps are found in approximately 50% of premenopausal women referred for ultrasound evaluation of abnormal uterine bleeding. 1,5-7 However, the prevalence of both lesions is lower in nonselected populations of perimenopausal women being evaluated for their initial complaint of abnormal bleeding. 8 These lesions are also found in asymptomatic women. 1 Endometrial polyps and leiomyomata are frequently removed surgically because of their association with abnormal uterine bleeding. 1,9 Despite the high prevalence of these conditions and the morbidity attributed to them, little is known about their natural history.In 1999, using saline infusion sonography, we compared the prevalence of benign uterine lesions in 80 women with abnormal uterine bleeding to a cohort of 100 asymptomatic premenopausal women over age 30 years. 1 We detected polyps in 10% and leiomyomata in 13% of the asymptomatic controls. In our current study, we add to the understanding of the natural history of uterine polyps and leiomyomata. By reevaluating this group of initially asymptomatic women, we aimed to estimate the incidence rate and regression rate of uterine leiomyomata and polyps, as determined by saline infusion sonography. MATERIALS AND METHODSThis study was approved by the Universit...

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Section: Discussionmentioning

confidence: 99%

Natural History of Uterine Polyps and Leiomyomata

DeWaay

Syrop

Nygaard

et al. 2002

Obstetrics & Gynecology

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“…No validation of sonographic findings was carried out, as the interobserver agreement of experienced gynaecologists is good. 14 …”

Section: Methodsmentioning

confidence: 99%

Open-access transvaginal sonography in women of reproductive age with abnormal vaginal bleeding: a descriptive study in general practice

Vries¹,

Waard²,

Bindels³

et al. 2011

Br J Gen Pract

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BackgroundDiagnostic ultrasonography is used by GPs in approximately 10% of patients of reproductive age with abnormal vaginal bleeding. Transvaginal sonography is recommended as a first-line diagnostic instrument for assessing uterine pathology. AimTo assess if findings resulting from openaccess sonography were in agreement with the GPs' working hypotheses and if these findings contributed to GPs' management. Design and settingProspective observational cohort study of GPs working in the health district of the Academic Medical Center, Amsterdam and their patients consulting with abnormal vaginal bleeding. MethodData on patients' history, GPs' primary working hypotheses, and intended management were recorded. After sonography, GPs recorded their actual management. ResultsA total of 122 patients were included by 18 GPs from June 2003 to December 2004. Data from 89 patients were available for analysis. The GPs' working hypotheses implied 'no structural pathology' in 65/89 patients, and 'fibroids' in 24/89 patients. Sonographic findings were confirmed in 50/65 patients where 'no structural pathology', and in 14/24 of those where 'fibroids' were expected. Initially, GPs had intended to refer nine patients to a gynaecologist. Actual management after sonographic assessment was watchful waiting or drug therapy in 57/89 patients. Eighty-nine per cent of these patients had normal sonographic findings. The actual referral rate rose to 27/89 patients. In 17 referred patients, sonographic findings were suggestive of intracavitary abnormalities. ConclusionOpen-access sonography contributed to more accurate diagnoses and improved GPs' management of women with abnormal vaginal bleeding.

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“…Die Reproduzierbarkeit der mittels transvaginaler Sonographie erhobenen Befunde bei Patientinnen mit perimenopausalen Blutungen ist gut, wobei grösste Übereinstimmung in der Beurteilung des Cavum uteri mit normaler Anatomie gefunden wird [14].…”

Section: Nur Die Invasiven Und Histomorphologischenunclassified

Guideline: Abklärung von perimenopausalen Blutungsstörungen

2004

Gynäkol Geburtshilfliche Rundsch

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The reproductibility of the results of transvaginal sonography of the uterus in patients with abnormal uterine bleeding

Cited by 19 publications

References 0 publications

Natural History of Uterine Polyps and Leiomyomata

Natural History of Uterine Polyps and Leiomyomata

Open-access transvaginal sonography in women of reproductive age with abnormal vaginal bleeding: a descriptive study in general practice

Guideline: Abklärung von perimenopausalen Blutungsstörungen

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