Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps

Abstract

Background. The diagnostic accuracy of transvaginal ultrasonography and vaginal sonohysterography in detecting endometrial polyps in women suffering abnormal uterine bleeding are compared. Methods. One hundred and six patients suffering from menometrorrhagia were studied. To detect whether there was endometrial polyp or not, these patients were subjected to transvaginal ultrasonographic examination as well as to sonohysterography. The final diagnosis was established by diagnostic hysteroscopy and its guided biopsy. Results. Transvaginal ultrasonography resulted in false positive and false negative rates of 25% and 36.2% respectively while the figures with sonohysterography were 5.4% and 8% respectively. Combining both techniques further improved such rates to 2.9% and 2.8% respectively but not significantly (p > 0.1). The sensitivity and specificity were 64.5%, 75.5% for transvaginal ultrasonography, and 93.1%, 93.9% for sonohysterography (significantly higher: p < 0.001). Conclusions. Sonohysterography is significantly more accurate than transvaginal ultrasonography in the detection of endometrial polyps in cases with abnormal uterine bleeding. Combining both techniques did not significantly improve the diagnostic accuracy. Sonohysterography is an accurate and cost effective method which requires a little skill.