The place of transvagınal ultrasonography saline infusion sonohysterography and hysteroscopy in the diagnosis of abnormal uterine bleedings

Aim: To establish the accuracy oftransvaginal ultrasonography, saline infusion sonohysterography and hysteroscopy in diagnosing uterine pathology in patients with abnormal uterine bleeding. Material Metod : In our study, Transvaginalultrasonography (TVUSG), Saline infusion sonohystygraphy (SIS) and Hysteroscopy were applied to 60 patients in the reproductive period, who did not use any contraception method other than condom, who did not have chronic and systemic diseases, who applied to our clinic with abnormal uterine bleeding. Dilatation & Curettage (D&C) was applied to all patients after the procedure. Histopathology results obtained with D&C were compared with those obtained with TVUSG, SIS and Hysteroscopy. Results: Histopathologically,28 patients (46.7%) endometrial polyp, 4 patients (6.7%) submucomyomia, 10 patients (16.7%) endometrial hyperplasia was in the form of endometrial changes due to cycle irregularities in 18 patients (30%). The sensitivity, specifieity, positive and negative predictive values for detection of intracavitary pathology by transvaginal sonography were 71,42%, 77,78%, 88,23%, 83,85%. The value s determined by saline infusion sonohysterography were respeetively 88.89%, 90,48%, 80.00%, 95.0% and the values determined by hysteroseopy were respeetively 100%,90.00%,95,24%, 100%. Conclusion: TVUSG and SIS is a cheaper, easier and highly diagnostic value procedure for detecting endometrial pathologies such as endometrial polyps and submucous myomas. However, due to the high diagnostic values, low complication rates, direct biopsy and simultaneous treatment, we believe that hysteroscopy will maintain its 'gold standard' feature in the diagnosis and treatment of endometrial pathologies for many years.

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