Sonohysterography in premenopausal women with and without abnormal bleeding

Objective: To estimate the prevalence of abnormalities detected by sonohyst erography in premenopausal. women who were asymptomatic or had abnormal ute rine bleeding. Methods: Standard sonohysterography was done in 100 asymptomatic premenopau sal women age 30 and older. The prevalence of uterine abnormalities was rec orded and compared with findings in 80 premenopausal women evaluated in our unit for abnormal uterine bleeding. Results: Compared with asymptomatic women, premenopausal women with abnorma l uterine bleeding had a higher prevalence of polyps (33 versus 10%), intra cavitary myomas (21 versus 1%), and intramural myomas (58 versus 13%). Ten percent of asymptomatic women had polyps, but these polyps tended to be sma ller than the polyps found in women with abnormal bleeding (8.5 versus 13.9 mm, P =.064), Polyps were associated significantly with myomas, and both w ere more common in older premenopausal women. Conclusion: Intracavitary lesions and intramural myomas are more prevalent in women with abnormal uterine bleeding than in asymptomatic women, suggest ing a causative relationship. However, small endometrial polyps are common and frequently asymptomatic (Obstet Gynecol 1999;94: 516-20. (C) 1999 by Th e American College of Obstetricians and Gynecologists.).