Saline contrast sonohysterography in the preoperative assessment of benignintrauterine disorders

Objectives To assess the value of saline contrast sonohysterography (SCSH) in the preoperative evaluation of benign intrauterine lesions. Design Patients presenting with abnormal bleeding related to benign uterine pathologies and scheduled for surgical treatment were prospectively enroll ed in a study conducted between 1 January 1996 and 31 December 1997. SCSH w as first carried out with the intention of establishing further surgical ma nagement (hysterectomy or hysteroscopy). The end point of the study was to compare the surgical option ultimately carried out with the one decided aft er SCSH. In addition, size and location of intrauterine lesions determined by SCSH were compared with those issued from surgical records. Similarly, p athologic results were juxtaposed to SCSH diagnosis. Statistical analysis u sed non-parametric and correlation tests. Results Two hundred and thirty-three patients were included in the study, 3 9.5% of whom were postmenopausal. SCSH was consistently effective in the ch oice of the best surgical method, because no hysterectomy was required when an operative hysteroscopy was indicated on SCSH data. Similarly, only one patient treated by hysterectomy (5.8%) could have undergone a more conserva tive approach. But this patient had a genital prolapse, and thus hysterecto my was a part of the treatment. SCSH correlated well with surgery for the l ocation and size of intrauterine lesions (P < 0.001). SCSH was accurate in the diagnosis of polyps and submucous myomas (sensitivity 85.7%, specificit y 95.4%). Conclusions SCSH appears an important tool for preoperative assessment of b enign intrauterine pathologies. It should be used in the selection of patie nts that should be scheduled for an operative hysteroscopy.