Comparison of Diagnostic Hysteroscopy and Saline Infusion Sonography in Abnormal Uterine Bleeding
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 5307-5313
Abnormal uterine bleeding (AUB) is a common symptom in postmenopausal women and its association with endometrial cancer in this group warrants investigation.Recently, saline infusion sonography (SIS) hasbecome a fetching alternative to hysteroscopy. However, its diagnostic accuracy is not well established.
To evaluate and compare the diagnostic accuracy of SIS and hysteroscopy for diagnosing AUB.
Material and Methods
This cross-sectional, observational study was conducted in 35 randomly selected pre- and peri-menopausal patients with AUB. SIS was performed one day before surgery, after distension of the uterine cavity with 15-30 mL of saline. On the same day hysteroscopy was also performed. After the hysterectomy was performed, findings from histological examination of the hysterectomy specimen were compared with those from SIS. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for SIS and hysteroscopy. Cohen’s kappa was used to show the diagnostic agreement between histopathology, SIS, and hysteroscopy.
The maximum number of cases were in the age group of 41 to 45 years (40%) and 36 to 40 years (37.1%). The most common presenting complaint was menorrhagia (57.14%). The sensitivity of SIS was 92.86% and specificity was 85.71% with an accuracy of 88.57%, whereas the sensitivity of hysteroscopy was 100%, specificity was 95.24%,and accuracy was97.14% compared to those of histopathological findings. The kappa coefficient (0.9412) indicated an almost perfect agreement between histopathology and hysteroscopy and substantial agreement between SIS and histopathology (0.7674).
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