Three-dimensional sonohysterography may replace hysteroscopy for women with perimenopausal bleeding

Objective To investigate whether three-dimensional saline-infusion transvaginal sonohysterography can replace hysteroscopy in the detection of intrauterine lesions in women with perimenopausal bleeding. Materials and methods This study was carried out at the Department of Obstetrics and Gynecology, Menofyia University Hospital in Egypt. Fifty women who presented with perimenopausal bleeding and fulfilled the inclusion criteria were recruited for the study. Three-dimensional sonohysterography was performed followed by hysteroscopy for all women. Results were tabulated and statistically analyzed. The accuracy of both techniques was calculated in terms of sensitivity, specificity, positive and negative predictive values. Results The mean age of women enrolled was 47.5 +/- 5.61 years and the mean body mass index was 28.13 +/- 2.91 kg/m(2). Three-dimensional sonohysterography detected no abnormality in 26 women but hysteroscopy only detected 24 with no abnormality. Compared to hysteroscopy, three-dimensional sonohysterography has sensitivities of 100% and 92% in the detection of endometrial polyps and submucous fibroids, respectively. The specificity of sonohysterography for both lesions was 100%. The sensitivity and specificity for other lesions exceeded 95%. Conclusions Three-dimensional sonohysterosonography may be considered as an effective alternative to hysteroscopy in the assessment of the uterine cavity for any woman with perimenopausal bleeding.