VALUE OF SONOHYSTEROGRAPHY IN THE DIAGNOSIS AND MANAGEMENT OF ABNORMAL UTERINE BLEEDING

PURPOSE: To assess the value of sonohysterography in the diagnosis and management of abnormal uterine bleeding. MATERIALS AND METHODS: Sonoh ysterography was performed in 28 women (aged 29-55 years) in whom tran svaginal sonography (TVS) suggested an abnormal endometrial echo (n=14 ) or fibroids (n=14). Its effect on diagnosis and treatment was studie d. RESULTS: In the patients with an abnormal endometrial echo, sonohys terography depicted endometrial polyps (n=9), intracavitary fibroids ( n=3), placental polyp (n=1), and a normal cavity (n=1). Hysteroscopic resection resolved the bleeding in 11 of 14 patients; surgery was obvi ated in one. In the group with fibroids, sonohysterography depicted sm all submucous fibroids amenable to hysteroscopic myomectomy (n=5), a s mall mural fibroid with a normal cavity, which obviated surgical inter vention (n=4), and endometrial polyps, which altered the treatment pla n (n=1). Sonohysterography suggested the need for an abdominal myomect omy (n=4) and alerted the surgeon to explore the uterine cavity in thr ee patients. CONCLUSION: By helping elucidate the cause of bleeding, s onohysterography assisted in determining the therapeutic approach and often reduced the level of surgical intervention or obviated it altoge ther.