DIAGNOSTIC HYSTEROSCOPY AND SONOHYSTEROGRAPHY IN THE EVALUATION OF PERIMENOPAUSAL BLEEDING

Abstract

Abnonnal uterine bleeding in perimenopausal women is a common disorder that has to be investigated properly, there are several factors causing it: uterine fibroid, endometrial polyp, endometrial hyperplasia, adenocarcinoma and dysfunctional uterine bleeding.

In the last ten years sonohysterography has developed as a less invasive procedure than hysteroscopy but more infonnative than transvaginal sonography. Transvaginal sonography is an attractive modality in evaluating the uterus and endometrium. Sonohysterography was developed to incorporate some of the advantages of hysterosalpingography such as demonstration of endometrial cavity anatomy and fallopian tube anatomy and patency, with the advantage of real time ultrasound, such as ease of use, visualization of myometrial anatomy, and the ability to evaluate adnexal pathology. Sonohysterography can be done with saline or with glycine or echovist, saline sonohysterography is considered simple, applicable and easy technique.

In the present study we wished to evaluate the accuracy of sonohysterography in cases of perimenopausal bleeding as compared to hysteroscopy.

The present study included 34 participants with abnonnal uterine bleeding, which were recruited from the Gynecologic clinic in the department of Obstetrics and Gynecology Kasr El Aini Hospital, Cairo University, during the period from May 2000 to May 200I.

History taking and complete general and local examination were done, routine investigations were perfonned before proceeding for hysteroscopy and sonohysterography.The following were evaluated :intracavitary lesions, filling defects or anomalies.