scholarly journals A Comparative Observational Study of the Use of Saline Uterine Hydrosonography for the Diagnosis and Assessment of Uterine Cavity Lesions in Women

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Veluppillai Vathanan ◽  
Nii Adjeidu Armar
Keyword(s):  
Predictive Value ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Diagnostic Efficacy ◽  
Endometrial Polyps ◽  
Saline Infusion Sonography ◽  
Middlesex Hospital ◽  
Diagnostic Hysteroscopy ◽  
Intrauterine Abnormalities ◽  
Transvaginal Ultrasound Scan

Aim of this study was to evaluate the performance of saline hydrosonography (HSGM) (also known as saline infusion sonography (SIS)) against transvaginal ultrasound scan (TVS) and hysteroscopy in the diagnosis of uterine cavity lesions. Diagnostic hysteroscopy with biopsy is considered as the “gold standard” to diagnose intrauterine abnormalities. The introduction of HSGM has improved the diagnostic capability of ultrasound. It is important to establish the efficacy and safety of HSGM before it is widely recommended for use. This retrospective observational data was collected from all 223 patients who underwent TVS, HSGM, and hysteroscopy as part of their gynaecological investigations from 1 January 2008 to 31 December 2010 at Central Middlesex Hospital, London.Endometrial Polyps. TVS: sensitivity 60.53%, specificity 97.06%, positive predictive value (PPV) 95.83%, and negative predictive value (NPV) 68.75% and HSGM: sensitivity 95%, specificity 97.14%, PPV 97.44%, and NPV 94.44%.Submucous Leiomyoma. TVS: sensitivity 57.14%, specificity 93.48%, PPV 84.21%, and NPV 78.18% and HSGM: sensitivity 96.55%, specificity 100.00%, PPV 100.00%, and NPV 97.92%. Diagnostic efficacy of HSGM is superior to TVS for the diagnosis of endometrial polyps and submucous fibroids. HSGM should be considered as an intermediate investigation after TVS to assess intracavity pathology and to confirm the diagnosis; hysteroscopy should become a therapeutic intervention.

scholarly journals Three-dimensional Transvaginal Ultrasound vs Office Hysteroscopy for Assessment of Uterine Cavity in Assisted Reproductive Program

2016 ◽  
Vol 8 (4) ◽  
pp. 290-293
Author(s):  
Ushma Patel
Keyword(s):  
Predictive Value ◽  
Transvaginal Ultrasound ◽  
False Negative ◽  
Three Dimensional ◽  
Uterine Cavity ◽  
Safe Procedure ◽  
Office Hysteroscopy ◽  
Diagnostic Efficacy ◽  
Menstrual Cycles ◽  
Negative Results

ABSTRACT Introduction The success of an assisted reproductive program (ARP) depends on the embryo quality and the intrauterine environment. It has been reported up until now that abnormal uterine findings occur in nearly 34 to 62% of infertile women worldwide. Due to this reason, uterine cavity evaluation is commonly recommended to screen for fibroids, polyps, adhesions, and mullerian abnormalities. Uterine cavity evaluation is usually accomplished with three-dimensional (3D) transvaginal ultrasound (TVS), sonohysterography, hysterosalpingography, and office hysteroscopy (OH). Materials and methods Uterine cavity evaluation was carried out in 239 infertile females undergoing ARP with twodimensional (2D) followed by 3D vaginal ultrasonography on day 21 of their menstrual cycles. Later, OH was carried out on 5th or 6th day of menstrual cycles. Results Out of 239 women, 3D TVS was abnormal in 28 (11.71%) and OH was abnormal in 53 (22.17%). Three-dimensional TVS agreed with OH in 16 (30.18%) abnormal cases and 179 (93.71%) normal cases. False-positive results for 3D TVS were 12 (6.28%) and false-negative results were 37 (69.81%). In our study, sensitivity of 3D TVS was 30.1%, specificity was 93.7%, positive predictive value was 57.1%, and negative predictive value was 82.8%. Conclusion Office hysteroscopy is an easy and safe procedure and has a better diagnostic efficacy than 3D TVS for uterine cavity evaluation in women undergoing ARP. How to cite this article Mishra VV, Patel U, Gandhi K. Threedimensional Transvaginal Ultrasound vs Office Hysteroscopy for Assessment of Uterine Cavity in Assisted Reproductive Program. J South Asian Feder Obst Gynae 2016;8(4):290-293.

scholarly journals Diagnostic Hysteroscopy in Abnormal Uterine Bleeding: A Prospective Analytical study

2020 ◽  
Vol 11 (4) ◽  
pp. 8087-8091
Author(s):  
Karthiga Prabhu J ◽  
Sunita Samal ◽  
Shanmugapriya Chandrasekaran ◽  
Maitrayee Sen ◽  
Balaji Ramraj
Keyword(s):  
Predictive Value ◽  
Analytical Study ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Cervical Canal ◽  
Age Group ◽  
Abnormal Growth ◽  
Dilatation And Curettage ◽  
Diagnostic Hysteroscopy ◽  
Intrauterine Abnormalities

Localized lesions like a polyp or abnormal growth can be missed by traditional dilatation and curettage whereas such intrauterine abnormalities can be easily diagnosed by hysteroscopy as we can directly visualise the cervical canal and uterine cavity. The objective of our study was to assess the diagnostic accuracy of hysteroscopy in diagnosing the cause of AUB and to correlate hysteroscopy findings with histopathology.  This prospective study was conducted in women with symptoms of AUB in the reproductive, perimenopausal and postmenopausal age group who had underwent hysteroscopy over a period of 2 years. Hysteroscopic findings and histopathology findings were compared. The main symptoms for which hysteroscopy was performed was postmenopausal bleeding (44.1%) followed by menorrhagia (33.8%). Hysteroscopy detection of abnormal findings had a sensitivity 90%, specificity 87.5%, positive predictive value 98.2% and negative predictive value 53.8%. To conclude hysteroscopy improves the accuracy of diagnosing intrauterine pathologies and also helps in treating some causes of AUB by simple procedures in the same sitting thereby avoiding major surgeries.

scholarly journals The Prevalence and Pattern of Abnormal Hysteroscopy Findings among Subfer-tile Patients at Albayda Fertility Centre/Libya

2020 ◽  
Vol 35 (1) ◽  
pp. 37-45
Author(s):  
Agzail S Elhddad ◽  
Zamzam Shaban
Keyword(s):  
Prospective Study ◽  
Uterine Cavity ◽  
Endometrial Polyps ◽  
Infertile Women ◽  
Spontaneous Pregnancy ◽  
Uterine Septum ◽  
Diagnostic Hysteroscopy ◽  
Intrauterine Abnormalities ◽  
A Prospective Study

To estimate the prevalence and types of intrauterine abnormalities in subfertile women: a prospective study was carried out at Albayda Fertility Teaching Centre-Libya. The study was conducted on 115 infertile women attending Albayda Fertility Centre between January and May 2019. Diagnostic hysteroscopy was conducted after initial basic infertility assessment workup to assess the presence and types of uterine cavity pathologies. The duration of infertility ranged from 1-17 years, and the majority of the patients were presented with primary infertility (62.6%), 64.3% of the women had abnormal findings, and the most common lesion detected was endometrial polyp representing 44.6% of the lesions, followed by endometritis 17.6%. Seven cases had septum, and 20 patients had more than one pathology. Corrective measures were taken accordingly. 6.1% of the patients had a spontaneous pregnancy within three months of follow up. The prevalence of abnormal hysteroscopy findings among the studied population was high. Intrauterine endometrial polyps, endometritis, and uterine septum were the most frequent abnormality detected. These findings may indicate a need to incorporate hysteroscopy in the routine evaluation of infertility.

Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

2020 ◽  
Vol 103 (6) ◽  
pp. 585-593
Keyword(s):  
Predictive Value ◽  
Final Diagnosis ◽  
Saline Infusion ◽  
Transvaginal Ultrasonography ◽  
Histopathological Diagnosis ◽  
Endometrial Polyps ◽  
Saline Infusion Sonography ◽  
Submucous Myoma ◽  
Kappa Value ◽  
Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

scholarly journals Hysteroscopy is Gold standard in Uterine evaluation for Infertility, but HSG still has a place

2021 ◽  
Vol 12 (4) ◽  
pp. 98-104
Author(s):  
Manisha Bajaj ◽  
Rajib Roy ◽  
Motiur Rahman ◽  
Joydeb Roychowdhury
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Screening Method ◽  
Uterine Cavity ◽  
High Specificity ◽  
Filling Defect ◽  
Endometrial Polyp ◽  
Care Hospital ◽  
Saline Infusion Sonography ◽  
First Choice

Background: Uterine abnormalities, congenital or acquired are implicated as causal factor in 10%-15% of infertile couplesreporting for treatment. Hysteroscopy, hysterosalpingography (HSG), saline-infusion-sonography and USG are available for evaluation of uterine cavity. HSG helps in initial evaluation of a sub-fertile woman, but hysteroscopy is gold standardas itallows direct visualisation ofintrauterine pathology and treatment in same-setting, if required. Aims and Objective: To describe hysteroscopic findings of infertile patients and compare the observations with their respective HSG findings. Materials and Methods: It’s a prospective analysis of 105 women with infertility who attendedtertiary-care hospital during 18 monthsfulfilling pre-defined inclusion and exclusion criteria. All cases were evaluated with both HSG and hysteroscopy, observations were recorded and co-related with each other. Results: Among 105 cases, maximum (76.19%) were 25-35 years of age. The primary infertility accounted for 68.57% cases.Abnormal HSG findings observed in 19 cases (20%), most common being filling-defect.Hysteroscopy detected abnormalities in 39 cases (37.14%), commonest being endometrial polyp. Out of 39 cases of abnormal uterine cavity detected on hysteroscopy only 19 were picked-up by HSG, rest 20 cases failed to be identified. The strength of agreement between hysteroscopy and HSG calculated is moderate (Kappa=0.505). Conclusion: As HSG hadlow false positivity (03%), high positive-predictive-value (90.48%) and negative-predictive-value (76.19%) and high specificity (96.96%) it is still considered as a first-choice screening method of uterine cavity. However, high false-negative-value (51.28%)of HSG makes Hysteroscopy a better diagnostic test. HSG couldn’t differentiate endometrial polyp, adhesions and submucous fibroid, shown them as filling defect only.

scholarly journals Diagnostic hysteroscopy and saline infusion sonography in the diagnosis of intrauterine abnormalities: an assessment of patient preference

2010 ◽  
Vol 8 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Heleen van Dongen ◽  
Anne Timmermans ◽  
Cathrien E. Jacobi ◽  
Trudy Elskamp ◽  
Cor D. de Kroon ◽  
...  
Keyword(s):  
Patient Preference ◽  
Saline Infusion ◽  
Saline Infusion Sonography ◽  
Diagnostic Hysteroscopy ◽  
Intrauterine Abnormalities

scholarly journals Hysteroscopic polypectomy versus expectant management in endometrial polyps in asymptomatic infertile women: a meta-analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 3096
Author(s):  
Tauane Bahia Modesto ◽  
Amanda Tamiris Barbosa Dias ◽  
Sofia Andrade De Oliveira
Keyword(s):  
Pregnancy Rate ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Uterine Cavity ◽  
Expectant Management ◽  
Implantation Rate ◽  
Endometrial Polyp ◽  
Structural Abnormality ◽  
Endometrial Polyps ◽  
Intrauterine Abnormalities

Background: Endometrial polyp is a hyperplastic structural abnormality of the uterine cavity and is one of the most commonly found intrauterine abnormalities. The endometrial polyp is mostly asymptomatic and sometimes diagnosed only during infertility investigation. The influence of endometrial polyps on female infertility is not completely understood, however, due to the possibility of endometrial polyps influencing fertility, their removal is usually performed in women undergoing infertility treatment.Methods: This meta-analysis was performed through an electronic search using MEDLINE, PubMed in October 2017, bringing together the terms of interest in order to select studies that would compare polypectomy and expectant management for endometrial polyps in sub fertile women. Four articles were selected according to the inclusion and non-inclusion criteria.Results: Five variables were collected from the selected articles to be compiled and analyzed (rate of live births per transferred embryo, chemical pregnancy rate, spontaneous abortion rate, implantation rate and clinical pregnancy rate), none of which showed any difference statistically significant in conduct.Conclusions: The data concluded that there is no statistical significance between expectant management and polypectomy.

Use of ultrasound imaging for the diagnosis of abnormal uterine bleeding in the bonnet macaque (Macaca radiata)

2016 ◽  
Vol 51 (1) ◽  
pp. 65-74
Author(s):  
Uddhav K Chaudhari ◽  
M Imran ◽  
Dhananjay D Manjramkar ◽  
Siddhanath M Metkari ◽  
Nilesh P Sable ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
3D Ultrasound ◽  
Uterine Bleeding ◽  
Colour Doppler ◽  
Endometrial Polyps ◽  
Non Invasive ◽  
Uterine Anomalies

Ultrasound is a powerful, low-cost, non-invasive medical tool used by laboratory animal veterinarians for diagnostic imaging. Sonohysterography and transvaginal ultrasound are frequently used to assess uterine anomalies in women presenting with abnormal uterine bleeding (AUB). In the present study, we have evaluated the abdominal ultrasound of bonnet monkeys ( n = 8) showing spontaneous ovulatory ( n = 5) and anovulatory ( n = 3) AUB. The ovulatory ( n = 5) macaques showed cyclic AUB for 7–8 days. The anovulatory ( n = 3) macaques had irregular AUB with menstrual cycles of 40–45 days. The B-mode abdominal, colour Doppler and 3D ultrasound scans were performed during the proliferative phase of the menstrual cycle. Ultrasound examination revealed endometrial polyps in five macaques and endometrial hyperplasia in three animals. The width and length of endometrial polyps was around 0.5–1 cm (average 0.51 ± 0.23 cm × 0.96 ± 0.16 cm) with significant increase in endometrial thickness ( P < 0.0002). 3D ultrasound also showed a homogeneous mass in the uterine cavity and colour Doppler ultrasound showed increased vascularity in the endometrial polyps. Endometrial hyperplasia characteristically appeared as a thickened echogenic endometrium ( P < 0.0002). This study demonstrates the use of non-invasive ultrasound techniques in the diagnosis of AUB in macaques.

scholarly journals Hysterosalpingography Vs Hysteroscopy in the Detection of Intrauterine Pathology in Infertility

1970 ◽  
Vol 7 (1) ◽  
pp. 6-9 ◽  
Author(s):  
B Shakya
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
University Teaching ◽  
Endometrial Polyps ◽  
Proliferative Phase ◽  
Submucous Myoma ◽  
Health Research Council ◽  
Prospective Comparative Study

Background: This study was to compare the accuracy of hysterosalpingography (HSG) with hysteroscopy (HSC) in detection of uterine pathology in patients with infertility. Methods: This is a prospective comparative study done among 50 new cases of primary and secondary infertility presenting to infertility clinic of Tribhuvan University Teaching Hospital from March 2006 - 2007. HSG was performed in the proliferative phase of menstrual cycle followed by HSC in the proliferative phase of the same or the following cycle. Intra uterine findings on HSG were evaluated and compared with hysteroscopic findings. Results: Out of 50 cases, HSG revealed normal findings in 49 cases (98%) and HSC demonstrated normal uterine cavity in 44 of the cases (88%). There was one abnormality (2%) shown on HSG (subseptate uterus) which was confirmed at HSC. HSC demonstrated six cases (12%) of intrauterine pathologies and these were endometrial polyps, subseptate uterus and submucous myoma. HSG in the detection of intrauterine pathology had a sensitivity (SV) of 16.7% (95% CI 0.9-63.5), specificity (SP) 100% (95% CI 90-100), positive predictive value (PPV) 100% (95% CI 5.5-100), negative predictive value (NPV) 89.8% (95% CI 77-96.2), false negative rate (FNR) 83.3% and accuracy rate (AR) 90%. Conclusion: HSG is a specific, but not sensitive predictor of uterine pathology. However, HSG did not provide any additional finding in comparison to HSC. Therefore, HSG is not advisable in the detection of uterine pathology in infertility patients.Key words: diagnostic hysteroscopy, hysterosalpingography, infertility, uterine cavity.   DOI: 10.3126/jnhrc.v7i1.2271 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 6-9

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