COMPARISON OF SALINE INFUSION SONOGRAPHY WITH OFFICE HYSTEROSCOPY FORTHE EVALUATION OF THE ENDOMETRIUM

OBJECTIVE: Intrauterine infusion of saline solution during transvagina l ultrasonography enhances visualization of the endometrium. We compar ed the accuracy and pain rating of saline infusion sonography with tho se of flexible office hysteroscopy. STUDY DESIGN: The uterine cavities of 130 patients with abnormal bleeding were evaluated by two physicia ns in an office setting. Findings of endometrial polyps, submucous myo mas, synechiae, endometrial hyperplasia, or cancer were recorded indep endently and subsequently compared. Patients rated their pain after ea ch procedure. RESULTS: Both procedures were performed in 113 of 130 pa tients. With saline infusion sonography pathologic findings were ident ified in 61 patients (54%). For all findings combined, sensitivity was 0.96 and specificity was 0.88, compared with hysteroscopy. The result s of saline infusion sonography and hysteroscopy did not differ signif icantly (p = 0.18). The former was less painful for patients than hyst eroscopy (p < 0.0001). CONCLUSION: Saline infusion sonography is an ac curate and well-tolerated method to evaluate abnormal uterine bleeding , compared with hysteroscopy.