Purpose : The primary objective of this study is to evaluate the effectiveness of Saline Contrast Sonohysterography guided biopsy (SCSH GB) as compared with Endometrial Office Biopsy (EOB) in diagnosing endometrial pathologies by the adequacy of the sample and comparison of the pathologic diagnosis confirmed by hysteroscopy or hysterectomy (histological and anatomical).
Methods:Unselected consecutive 250 patients aged 40 years and above with AUB and abnormal endometrium on transvaginal ultrasound presenting to ultrasound unit and outpatient department at Women Specialized Hospital, King Fahad Medical City, Riyadh, KSA were screened for eligibility in this interventional study. Fifty percent of enrolled patients were initially booked for SCSH GB then scheduled for EOB. Whereas, the remaining 50% underwent EOB first and then had SCSH GB. This method was used to control the issue of insufficient biopsy. The diagnosis was categorized as 1) physiological 2) benign polyp or sub-mucous fibroid and 3) hyperplasia/cancer.
Results:Out of 113 patients 93 underwent both SCSH GB and EOB procedures and were entered into final data analysis. SCSH GB (94.6%) achieved significantly higher sample adequacy compared to 86% of EOB (p<0.001). SCSHGB significantly diagnosed all 29 (100%) polyps and sub-mucous fibroids confirmed by hysteroscopy/hysterectomy versus only 8 (27.5%) cases by EOB (p<0.001).
Conclusions:The SCSH GB technique can be a reasonable alternative to EOB in pre-and post-menopausal women aged 40 and older with AUB.