Saline infusion sonohysterography for uterine cavity evaluation in women with abnormal uterine bleeding

Mohamed Abd El-Sattar, Ahmed M. Abbas, Mohamed K. Tawfik, Mahmoud A. Fouad


Background: The aim of this study was to compare the diagnostic effectiveness of saline infusion sonohysterography (SIS) with hysteroscopy, as a gold standard diagnostic method, in detecting endometrial pathology in premenopausal women with abnormal uterine bleeding.

Methods: A prospective study was conducted at Al-Azhar University hospital, Assiut, Egypt. Fifty patients were recruited from the gynecological outpatient clinic complaining of abnormal uterine bleeding. They were evaluated by SIS and compared with hysteroscopic examination for each.

Results: The mean age of patients was 45.56±3.48 years. All the intracavitary lesions; endometrial polyps, submucous fibroids and hyperplastic endometrium were equally detected by both methods. Diagnostic accuracy of SIS in comparison with hysteroscopy was 76% with sensitivity 80%, specificity 72%.

Conclusions: SIS is a reliable and accurate method for evaluation of the uterine cavity. It can be a good alternative technique for the evaluation of uterine cavity abnormalities where hysteroscopy is not available.


Abnormal uterine bleeding, Saline infusion sonohysterography, Hysteroscopy

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Kelekci S, Kaya E, Alan M, Alan Y, Bilge U, Mollamahmutoglu L. Comparison of transvaginal sonography, saline infusion sonography, and office HS in repro-ductive-aged women with or without abnormal uterine bleeding. Fertil Steril. 2005;84:682-6.

Soguktas S, Cogendez E, Kayatas SE, Asoglu MR, Selcuk S, Ertekin A. Comparison of saline infusion sonohysterography and hysteroscopy in diagnosis of premenopausal women with abnormal uterine bleeding. Eur J Obstet Gynecol Reprod Biol. 2012;161(1):66-70.

Dreisler E, Sorensen SS, Ibsen PH, Lose G. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding. Ultrasound Obstet Gynecol. 2009;33:344-8.

Dueholm M, Forman A, Jensen ML, Laursen H, Kracht P. Transvaginal sonogra-phy combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding. Ultrasound Obstet Gynecol. 2009;18:54-61.

Mathew M, Gowri V, Rizvi SG. Saline infusion sonohysterography-an effective tool for evaluation of the endometrial cavity in women with abnormal uterine bleeding. Acta Obstet Gynecol Scand. 2010;89:140-2.

Abbas AM, Tawfik MK, Tammam AE, Abdellah AH, Mwafy A. The diagnostic value of saline infusion sonohysterography versus hysteroscopy in evaluation of uterine cavity in patients with infertility and recurrent pregnancy loss. Thai J Obstet Gynecol. 2015;23:113-7.

Krampl E, Bourne T, Solbakken HH, Istre O. Transvaginal ultrasonography, sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding. Acta Obstet Gynecol Scand. 2001;80:616-22.

Alfhaily F, Ewies A. The first-line investigation of postmenopausal bleeding: Transvaginal ultrasound scanning and endometrial biopsy may be enough. Int J Gynecol Cancer 2009;19:892–5.

Gimpelson RJ, Whalen TR. Hysteroscopy as gold standard for evaluation of abnormal uterine bleeding. Am J Obstet Gynecol. 1995;173:1637-8.

Glanc P, Betel C, LevToaff A. Sonohysterography: Technique and clinical applications. Ultrasound Clin. 2008;3:427-31.